Main Clinic Location: 630 Burnett Drive, Mountain Home, AR 72653

Patient Forms & Information

Thank you for choosing Regional Family Medicine for your health care needs. On this page you will find information for new patients, how to request your medical records, and HIPPA related patient information.
Important Notice
These forms will not transfer to us automatically! You will have to either print and fax them to us, or bring them by one of our locations.
New Patient Forms
Before your first appointment, please print the following forms and fill in the appropriate information. Be sure all forms are signed and dated where noted, and bring the forms, your insurance card(s), and a photo ID to your upcoming appointment. Please be HONEST and ACCURATE when you complete these documents.

Download individual forms here:

Request Medical Records
HIPPA Information
Recent News
Twin Lakes Best of the Best
Healthcare Advice When You Need It
SHARE – Arkansas’ Health Information Exchange
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