Gemp Dental Couple
 

 

 

 

 

 

Gemp Reconstructive and
Cosmetic Dentistry

50 Briar Hollow Lane
Suite 125 W.
Houston, TX 77027

Phone: (713) 960-9623
Fax: (713) 960-8682

Sugarland Office

3501 Town Center Blvd. South
Sugar Land, TX 77479

Email: dr.gemps_office@yahoo.com

 

Patient Forms

Staff in front of FoldersTo help new patients save time at the office, we have provided you with the forms you will need. If you are a new patient at this time, please do the following:

 

  • Print and fill out both pages of the Patient Information form
  • Read over our Privacy Practices
  • Print, date and sign the Acknowledgment of Receipt Privacy Form
  • Bring the printed forms to your first appointment


If you do not have the ability to print, these forms are also available at our office, and can be filled out prior to your appointment.

 

Patient Information (2 Pages)Full Staff Posing

Patient Information (print, fillout & bring)

Privacy Practices

Privacy Practices (read)

Acknowledgment of Privacy Practices (print, sign & bring)



 

Gemp Reconstruction and Cosmetic Dentistry
 

Gemp Reconstructive and Cosmetic Dentistry 50 Briar Hollow Lane, Suite 125 W. Houston, TX 77027
© Copyright 2009 Gemp Prosthodontics