Contact US New Patient forms Get ahead of the game! Download our patient registration forms online. These can be completed and printed in the comfort of your home to save you time at check-in. New Patient Form (ENG) New Patient Form (SPA) We're Ready! Let's Talk!Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Comment or Message *MessageSubmit CONTACT INFO 930 15th Street Batesville, AR 72501 870-262-8118 toothbetoldpd@gmail.com 870-569-8321 (fax) Facebook Instagram