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Online Patient Registration Form
 You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
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Notice of Privacy Practices
 To view our privacy practices statement, please click the icon on the left.
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Acknowledgement of Receipt of Notice of Privacy Practices
 Please download this form by clicking the icon on the left.
After downloading, please print the form, fill it out, and bring it to your appointment with us.
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Services provided: Wisdom Teeth Extraction, Orthognathic Surgery, Dental Implants, Facial Trauma,
Apicoectomy, TMJ (Temporomandibular Joint disorders), Cleft Palate, Sleep Apnea, Botox, Juvederm
Piney Point Oral & Maxillofacial Surgery
2450 Fondren, Suite 320 - Houston, TX 77063
Phone: (713) 783-5560 - Fax: (713) 783-3116
Drs. Weil and Koo are serving the greater Houston TX area including but not limited to: Stafford, Meyerland, Bellaire, Lamar Terrace,
Galleria, Briargrove, Rice Military, Heights, Bunker Hill Village, Hunters Creek Village, Hedwig Village
and Katy.
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