Please fill out the New Patient Waiting List form and mail it to us at 3650 W. College Ave, Conway, AR 72034. Or, you can complete the new patient waiting list form online. If you have questions, please contact our office at 501.327.6900.

If you are interested in becoming a new patient, please fill out the New Patient Waiting List Form (click button above) and mail it to our office at 3650 W. College Ave, Conway, AR 72034. We will be glad to add you to our waiting list file.

Please note that this form will be placed on our patient waiting list. Due to a high volume of new patient requests, response time could take up to 10 business days. In the meantime, if you are needing to be seen for an acute illness or injury there are several walk-in clinics in the Conway area.

This form will need to be completed prior to the new patient paperwork and before an appointment can be scheduled.

Please note that new patient applications are only kept for 90 days. If an appointment is not scheduled during that time, you will need to submit a new patient waiting list registration form.

If you are interested in becoming a new patient and prefer to complete the form online, please use the button above.

We accept most major insurance plans including:

• Health Advantage
• Qualchoice
• UMR
• United Healthcare