Patient Portal. Clinic Forms. CONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION. FINANCIAL POLICY. MEDICAL RELEASE FORM. PATIENT INFORMATION. PRIVACY POLICY AGREEMENT _____ Fonticiella Medical Clinic. 1000 West Kingshighway Ste 12. Paragould, AR 72450. ... will attempt to keep you informed of your doctor’s schedule. If you need to cancel ....