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Patients

Before Your Visit

Pre-Registration

We offer online Pre-Registration for your upcoming, scheduled visit. Please submit your information at least two business days before your arrival. If you’re experiencing a life threatening emergency, go directly to the ER or dial 9-1-1. This form is NOT intended for Emergency Room use.

Pre-Registration Form

Medical Records

Wadley Regional Medical Center at Hope maintains medical records for each patient treated at the hospital. To request your medical records, please visit our Health Information Management department between the hours of 8:00 am – 4:30 pm, Monday through Friday, or call 870-722-3853

Prior to receiving copies of records or authorizing records to be disclosed, you will be asked to complete the appropriate form and provide proof of your identification with a valid, government issued photo ID.

The appropriate form, along with a copy of your proof of identification, may be faxed to 870-722-3859.

Requests for medical records generally take up to 72 hours to process.

Request a Copy of PHI (English)

Request a Copy of PHI (Español)

The following form should be used for requests to disclose medical records to a third party.

Authorization to Release Records (English)

Authorization to Release Records (Español)

NOTE: Records needed for continuing care purposes do not require the completion of any of the above referenced forms, but rather will be sent directly to your provider.

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2001 South Main Street
Hope, AR 71801
870-722-3800
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