New Patient Forms

New Patient Forms

Welcome to our practice!


We are genuinely pleased that you have chosen us for your dental care. We are always excited to see new smiles coming through our door! In order to provide you with the best level of care, we need to get some information from you. Please fill out your new patient forms below, or plan to arrive 15 minutes early to your appointment to complete them in the office.


Online Form

Fill and Submit online


Printable Form

Three easy ways you get the form to us:

1. Print, fill and bring to the office

2. Email to us at info@perkdental.com

3. Fax it to us 281-692-2254



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