These new patient & medical history forms will help facilitate your appointment with Periodontist Dr. Samuel H. Adams II.Printable periodontal patient care forms

New Dental Patient & Medical History Forms

New patients will need to provide our office information regarding their present dental condition and previous medical history. This documentation is required so that our staff may assess, record and effectively treat the problems you are experiencing.

To make your first visit even more convenient, you can speed up this process by printing our forms and filling them out before your scheduled appointment. Simply click the image below (opens a new window) then press the print form button top-right.

Click for patient info forms
(two pages standard format)

Dr. Adams' Dental Practice Hours
Monday 8:00 a.m. - 5:00 p.m.
Tuesday 8:00 a.m. - 5:00 p.m.
Wednesday 7:30 a.m. - 3:30 p.m.
Thursday 8:00 a.m. - 5:00 p.m.
Friday 8:00 a.m. - 12:00 p.m.


An efficient, professional & accomplished periodontal practice!

Dr. Samuel Adams II, D.D.S.
550 Post Oak Blvd., Suite 550
Houston, Texas 77027
(713) 623-2260
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