Patient Application

Please download the patient application, fill it out, and bring them with you to your appointment.  NOTE: we are currently accepting applications for Medical patients only. You may also pick up an application at the clinic, call us at (501) 375-4400, or email our Clinic Manager, Connie, at connie@harmonyclinicar.org to request that we mail an application to you.

Click here to download a Patient Application in English

Click here to download a Patient Application en Espanol

Notice of Privacy Practices

You may download a copy of our current Notice of Privacy Practices below. You may also pick up a copy at the clinic, call us at (501) 375-4400, or email our Clinic Manager, Connie at connie@harmonyclinicar.org to request a copy.

Click here to download a copy of our Notice of Privacy Practices in English

Click here to download a copy of our Notice of Privacy Practices en Espanol