Online Forms

New Patient Health History Form

After you have set up an appointment, you can fill out our patient intake form here to make things quicker and easier for you. Once you fill out the online form and submit it, we will receive it in our office and be able to start getting everything set up for you in anticipation of your appointment.

Please note that filling out an online form before making an appointment will not guarantee you an appointment - you MUST call the office at 501-778-2121 to schedule your first appointment.

Fill out and Submit forms online*

*The online form works best with a computer or tablet. We have had reported issues that filling the form out on the phone will not allow you to sign it, thus making it unable to be submitted.



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Location

Doctor's Hours

Zerona Fat Loss Laser by Appointment

Doctor's Hours

Monday:

9:00 am-6:00 pm

Tuesday:

9:00 am-6:00 pm

Wednesday:

9:00 am-6:00 pm

Thursday:

9:00 am-6:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed