Forms

We attempt to see you at your appointed time as much as possible since we believe your time is as valuable as ours. If you would like to save some time, download our New Patient Registration form . This may be easily completed using your keyboard and mouse. Print the completed form and fax it to us or bring it with you to your first appointment.

To print our New Patient Registration Form, please click on the link above. You will need Acrobat Reader, which is a free software program available by clicking the Get Adobe Reader button below.

Get Adobe Reader

Contact Us

Ralph A. Teed, DDS, PA

Newport Office 

1200 McLain St. Newport, AR 72112 

870-523-6555 

Batesville Office 

2080 Harrison St Batesville, AR 72501 

870-698-8555