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New Patient Form

Our new patient forms are designed to give us a better understanding of your dental and medical history, as well as your current dental needs and concerns. By providing us with this information in advance, we can ensure that we are fully prepared for your visit, and can provide you with the best possible care.

Online New Patient Form


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Our Office

Galleria Perio & Implants

5858 Westheimer, Suite 820,
Houston, TX 77057

(713) 784-6065

Office Hours

  • Monday:   7:30 am - 3:30 pm
  • Tuesday:   7:30 am - 3:30 pm
  • Wednesday:   7:30 am - 3:30 pm
  • Thursday:   7:30 am - 3:30 pm
  • Friday:   7:30 am - 11:30 am
  • Saturday:   Closed
  • Sunday:   Closed