Arkansas Department of Human Services

Division of Aging and Adult Services
Provider Information for Reassessments and Reconsiderations


Click on New User Setup to send an email. Please make sure to include the required details listed below:

Required Details:

  1. Provider-Facility Name
  2. County (Main Office)
  3. Contact Person (First & Last Name)
  4. Telephone number with extension
  5. Contact Person't email address

Click here for Provider Submission Instructions

Click here for the Reassessment Form ***Note: Save a blank copy on your computer.  Also, make sure you enable editing so you can fill in the fields on the form.***

DHS Division of Aging and Adult Services | P.O. Box 1437 - Slot S-530 | Little Rock, AR 72203-1437 | 501.682.2441 | eMail
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