Release & Consent Forms
If you are seeking treatment for yourself, a family member or your patient at Rivendell Behavioral Health Services of Arkansas, please download and complete the documents below.
All requests for medical records should be sent to:
Sara Kennon, RHIT
Health Information Management Director
Credentialing Coordinator/Patient Advocate/Facility Privacy Officer
Rivendell Behavioral Health Services of Arkansas
100 Rivendell Drive
Benton, AR 72019
Fax: 501-794-3069
Email: [email protected]
Important Forms To Download
Seek Help Today
In case of a mental health crisis, CALL 988 or seek the nearest emergency room.
If you need to reach us immediately, call us at 800-264-5640.
Licensed mental health professionals are available 24 hours a day, 7 days a week to assist you or your loved one.
