Patient Forms

Download, Print, & Complete!

Bring completed forms with you to your appointment.

New Patient Forms

For your convenience, Health 1st Wellness & Physical Medicine provides our patients online forms that they can print and complete at home.  You may either fax your completed form (fax: 800-673-4512), or bring it with you to your first appointment.  This will reduce your wait time.

You will need AdobeReader® on your computer to open the form.  If you don’t already have it, Click Here to download.

New Patient Health History Form

Please fill out as much of the Intake form as possible. This lets us know your history, as well as your current health status.  The more information we have about your health history, the more we can accurately diagnose and treat your condition.


Health 1st Wellness & Physical Medicine

804 Higdon Ferry Road
Hot Springs, AR 71913

9307 Maumelle Boulevard
North Little Rock, AR 72113