Records Request


To request access to your BHSA records, please complete the form below:

REQUEST FOR ACCESS FORM

To provide authorization for BHSA to disclose your protected health information to another entity, please complete the form below:

AUTHORIZATION TO DISCLOSE HEALTH INFORMATION

To provide authorization for another entity to disclose your protected health information to BHSA, please complete the form below:

AUTHORIZATION FOR DISCLOSURE TO BHSA

To allow e-mail communication, please complete the form below:

CONSENT TO E-MAIL COMMUNICATIONS

Before Your First Visit

Please complete our appointment form and admission consents.

Complete Form

Meet Our Team

Read about our providers and their specialties.

learn more

Telehealth Services

Behavioral Health Services of Arkansas is offering telehealth services to allow our therapists to safely provide the uninterrupted, high-quality and personalized care you and your loved ones deserve.

Learn More

Before Your First Visit

Please complete our appointment form and admission consents. If you need to contact us, please click here

Complete Form

If you are having a medical emergency, please use a phone to dial 911.

Contact BHSA

If you have questions or comments, please feel free to use the information below to reach out to us. 

Address:
10 Corporate Hill Drive, Suite 330
Little Rock, Arkansas 72205
MAP

PHONE: 501-954-7470
FAX: 501-954-7420
EMAILcustomerservice@bhsarkansas.org

Hours:
Monday-Thursday: 8 am to 6 pm
Friday: 8 am to 5 pm