Patient Survey  |  Patient Forms

We strive to provide a welcoming environment to both our patients and their parents.

Once in the recall area, children spend time in the play area with toys, books, and stuffed animals.

Teens are seen in a more age appropriate environment.

The children will pick a "toothpaste" flavor; they are introduced to dental equipment
with friendly terms that will help them better understand the visit. 
Tooth brushing instructions are given to help children improve brushing and home care.

Hygienists are busy helping everyone get their teeth sparkly clean.

Younger siblings may be encouraged to watch in order to prepare them for the experience. 
Following the visit, children are invited to the prize window to choose a prize for being so cooperative.

About the First Visit

Dear New Parent,

We are pleased to have your child as a new patient to our office. We hope this letter will familiarize you with some of the services and procedures offered by Pediatric Dentistry.

Your child’s appointment will take approximately one to two hours. To facilitate being seen just as soon as possible, please complete the health history form and the financial form (found towards the bottom of the page), before your arrival. Remember to bring them with you at the time of your appointment.

If you are unable to make your scheduled appointment, please notify us at least 24 hours in advance to reschedule.

Our office hours are 8:30 to 5:30, Monday – Thursday. After school appointments are the most sought after appointment times during the school year, as such, shorter routine appointments such as six-month preventive checkups, orthodontic checks, and short office visits are scheduled after school for our school age children. Longer time consuming operative appointments, and appointments for preschool children are scheduled in the morning and early afternoon.


FIRST APPOINTMENT

It is our goal to have your child’s first appointment be informative and fun. During the first appointment, a thorough dental examination will be performed. Everything that we do will be explained to your child in friendly terms before we do it. A dental cleaning, fluoride treatment and x-rays may also be done depending on your child’s needs and your acceptance. Home care instructions will be given to each child and personalized to their individual needs. Time will be spent with you, the parent, to help you establish healthy, happy and positive dental habits with your child.

Our office is designed exclusively for treating young children and teens. Our staff is specially trained to meet your child’s needs and devoted to providing the highest quality of dental care. To insure your child has a successful first visit we suggest the following:

  • Schedule your child’s appointment for a time when they will be well rested and alert. Young children do better with early morning appointments.

  • Be upbeat about your child’s first visit, using friendly terms to explain the visit. Never use scary or frightening words.

  • Prepare any questions in advance regarding your child’s dental health. Dr. Cammarata and Dr. Sringam and their staff will answer any questions you might have after your child’s dental examination.

  • Give the center stage to Dr. Cammarata, and Dr. Sringam and their staff.

  • Parents are encouraged to be present during their child’s first visit. Your presence will be greatly enhanced if you assume the role of silent observer. Confusion results when too many people try to talk to the child at once. Allow us the opportunity to establish a relationship with your child.

  • Parents are always welcome to accompany their child during dental treatment. However, when you reach a level of comfort with our office environment, we encourage you to wait up front with other parents.

We require payment at the time of your first visit (cash, check, Visa, MasterCard, and American Express & Discover). Attached you will find additional information about our payment policies.

We look forward to meeting you and your child.


Patient Forms

For your convenience prior to visiting our office print out the forms and complete the information and bring it with you to your first visit.

Each child needs a health history form and a risk assessment form

Click here for Health History and Risk Assessment Form

Each family only needs one HIPPA form and one financial form

Click here for HIPPA Form and Financial Policies Form


Click here for Notice of Privacy Policies (Read Only)

To print the form you will need Adobe Acrobat Reader.  If you do not have Adobe Acrobat, please click here to download it for free to your computer.

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New Patient Survey

We value your opinion!  Please provide us with feedback concerning your first visit to our office.  Enter the information below and submit it online OR if you prefer to remain completely anonymous, you may click here to open a Printer Friendly copy, complete the information and mail or fax it to our office.

5252 Westchester, Suite 190
Houston, Texas  77005
(713) 666-7884    
fax (713) 666-5326

 

Childs Name (Optional)  
   
How did you learn about our practice?  
   
What influenced you to choose our practice?  
   
Did we meet your expectations?  
   
What was your child’s impression of their first dental visit?  
   
How could we improve the first experience?  
   
Comments:   
   
Please type "123" in the box at right to validate your response.  

 

 

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Pediatric Dentist in Houston, TX - Dr. Rita Cammarata - Servicing patients in the surrounding areas and suburbs of Houston, Texas

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Pediatric Dentist - Houston, TX
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