Resources and Forms


Arkansas Primary Care Clinic in Little Rock, AR gives resources that you can easily download and print. We also provide forms that you will have to fill out and present during your visit or consultation.

Patient Forms


Please download and fill out the forms and bring them with you on your visit. We are open on Mondays to Thursdays from 07:30 AM to 05:15 PM, as well as on Fridays from 07:30 AM to 12:30 PM.

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Notice of Data Security Incident


Little Rock, Arkansas – August 20, 2025 – Arkansas Primary Care Clinic (“APCC”), a medical services provider providing medical care to patients in Arkansas, announced it is notifying individuals whose personal information may have been involved in a network security incident. This statement is intended to notify potentially impacted individuals of the incident, steps APCC is taking in response, and resources available to assist and protect individuals.

On or about March 25, 2025, APCC discovered a network incident that impacted its IT systems. Immediately upon identifying the incident, APCC engaged third-party cybersecurity experts to assess, contain, and remediate the incident. Law enforcement was also notified.

The investigation into patient information exposure, which concluded on or around July 21, 2025, identified instances of name, address, date of birth, medical treatment information, billing information, and health insurance information exposure for certain patients as a result of this incident. While the investigation has not identified any instances of fraud or identity theft that have occurred as a result of this incident, out of an abundance of caution, APCC is notifying individuals whose personal information may have been involved and providing resources they can use to help protect their information.

APCC takes its responsibility to safeguard personal information seriously and regrets any concern this incident may have caused. As part APCC’s ongoing commitment to information security, the organization has taken steps to help reduce the likelihood of a similar event in the future.

As a general precaution, the following practices can help to protect you from medical identity theft.

  • Only share your health insurance cards with your health care providers and other family members who are covered under your insurance plan or who help you with your medical care.
  • Review your “explanation of benefits statement” which you receive from your health insurance company. Follow up with your insurance company or care provider for any items you do not recognize. If necessary, contact the care provider on the explanation of benefits statement and ask for copies of medical records to verify their accuracy and authenticity.
  • Ask your insurance company for a current year-to-date report of all services paid for you as a beneficiary. Follow up with your insurance company or the care provider for any items you do not recognize.

Individuals with questions may contact the dedicated call center at 1-833-426-4410 from 8:00 am to 8:00 pm (EST), Monday through Friday.

Arkansas Primary Care Clinic sincerely regrets any inconvenience or concern that this matter may cause and remains dedicated to ensuring the privacy and security of all information in its control.