UAMS Merchant Discount Request Form

UAMS Merchant Discount Form

Please note: UAMS is only accepting merchants within the Arkansas area. UAMS is not adding "web based only" merchants to the Merchant Discount Page (MDP) at this time. You will be contacted at the email address listed below within two weeks of submission. Contact us at 501-686-5650 or visit our website at Also, by applying to be featured on the UAMS Merchant Discount Page you are agreeing to offer this discount to all UAMS Employees, Students, and Alumni.
  • Date Format: MM slash DD slash YYYY
  • Contact Phone Number
  • Address where discount will be honored. If more than 1 location enter information in discount field below.