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Arkansas Medicaid forms

Arkansas Medicaid Forms

Some of the forms used by Arkansas Medicaid and its providers are available in electronic format. Others are added as they become available.

DMS Medical Assistance Dental Disposition (DMS-2635) (PDF, new window)

HP Financial Unit Stop Payment Affidavit (PDF, new window)

Office of Long Term Care Forms (HTML, new window) 

Prescription Drug Prior Authorization Forms (HTML, new window)

Provider Enrollment Forms

Section V of All Provider Billing Manuals (Word, new window)