Turn dental trauma enquiries into consultation-ready leads
Ask when the injury happened, what type of trauma occurred, and whether there's active pain or bleeding — then collect photos of the injured tooth before patients book, so your team can tell which cases need same-day chair time.
The exact intake your dental trauma treatment leads complete
This is the real 6-question guided intake for Dental Trauma Treatment — the same flow your customers finish before you ever pick up the phone.
What a qualified dental trauma treatment lead should tell you
Evaluation and treatment for a tooth injured by an impact, fall, or accident — covering chips, cracks, loosening, displacement, or full avulsion — where timing since injury and current symptoms determine how urgently the tooth needs to be seen.
- Did Injury Tooth Or
- Best Describes Injury
- Person Experiencing Pain Or
- This Injury Baby Tooth
- Tooth Already Been Seen
- Seeking Care Yourself Or
The questions your team needs answered
Every dental trauma treatment intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| When did the injury to the tooth or teeth occur? | How recently the injury occurred is a strong indicator of whether the tooth's pulp is still salvageable, so it drives most of the urgency scoring. |
| What best describes the injury? | The type of injury — chipped, loosened, knocked-out, or displaced — determines which endodontic approach and equipment your team needs to prepare for the visit. |
| Is the person currently experiencing pain or bleeding? | Active pain or bleeding signals a case that likely needs to be seen the same day rather than booked into a routine consultation slot. |
| Is this injury to a baby tooth or a permanent tooth? | Whether the injured tooth is a baby tooth or permanent tooth changes the entire treatment pathway, so it's critical for triaging pediatric cases correctly. |
| Has the tooth already been seen by any dentist or emergency provider since the injury? | Knowing whether the tooth was already assessed elsewhere helps distinguish a fresh trauma work-up from a continuing-care or second-opinion visit. |
| Are you seeking care for yourself or for someone else? | Identifying whether the patient is submitting for themselves, their child, or another adult in their care affects consent requirements and how the front desk should communicate. |
How Cliont scores dental trauma treatment leads
Every answer is weighted automatically — no manual review required.
Value signals
- Today
- Within the past week
- Within the past month
- Longer ago
- Person Experiencing Pain Or: yes
See the lead your team receives
Dental Trauma Treatment Lead
From first click to qualified lead
Follow patients and caregivers through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the visit
Smart questions adapt to their visit and capture the full scope.
They share details
Symptoms, history, and documents come attached before the visit.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for dental trauma treatment workflows
| Cliont capability | Dental Trauma Treatment application |
|---|---|
| Weighted scoring engine | Combines how recently the injury occurred with active pain or bleeding so same-day trauma cases with symptoms consistently outscore older, symptom-free injuries. |
| Multi-select answer capture | Captures every injury type a patient reports — chipped, loosened, knocked-out, or displaced — so complex multi-part injuries aren't reduced to a single category. |
| Conditional branching | Uses the baby-tooth-vs-permanent-tooth answer to route pediatric trauma cases differently from adult permanent-tooth cases before a consultation is booked. |
| Requestor relationship tagging | Records whether the submission is for the patient themselves, their child, or another adult in their care, so front-desk staff know who to contact and what consent applies. |
Common dental trauma treatment lead scenarios
Tooth knocked out today
Injury happened within hours and the intake flags active bleeding, so the case scores highest for same-day evaluation rather than a routine consultation slot.
Old chip, no current symptoms
The injury occurred longer ago with no pain or bleeding reported, so the lead scores lower on urgency and can be routed to a standard consultation booking.
Parent asking about a baby tooth
A parent selects that they're inquiring on behalf of their child and marks the injury as a baby tooth, which changes the clinical pathway from a permanent-tooth case.
Already seen at an ER
The patient confirms the tooth was already assessed by another provider since the injury, letting the intake distinguish a continuing-care case from a fresh trauma work-up.
Unsure what actually happened
The patient marks the injury type as 'Not sure,' so the case is still captured and scored on timing and symptoms while being flagged for a closer look before scheduling.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book visits
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More endodontics intake templates
Dental Trauma Treatment lead-intake FAQs
How does the intake decide which trauma leads need to be seen today versus at a routine consultation?
The intake weighs how recently the injury occurred against whether the patient is currently reporting pain or bleeding, so a same-day injury with active bleeding scores far higher than an older injury with no symptoms.
Does the intake treat a child's injured baby tooth differently from a permanent tooth?
Yes — the intake asks specifically whether the injury is to a baby tooth or a permanent tooth, since that distinction changes the appropriate clinical approach and how urgently the case should be triaged.
What happens if the patient was already seen by another dentist or an ER since the injury?
The intake asks whether the tooth has already been seen since the injury, which helps your team separate a fresh trauma work-up from a continuing-care or second-opinion case before it hits your CRM.
Can a parent submit an intake on behalf of their child?
Yes — the intake asks whether the patient is seeking care for themselves, their child, or another adult in their care, so submissions from parents or caregivers are tagged correctly for scheduling and consent purposes.
What if the patient isn't sure exactly what type of injury occurred?
The injury-type question includes a 'Not sure' option, so an uncertain patient still completes the intake and the case gets flagged for your team to clarify rather than being lost or misrouted.
How is this different from the intake for a cracked tooth evaluation?
Dental Trauma Treatment intake centers on injury timing, mechanism, and whether the tooth is baby or permanent, while Cracked Tooth Evaluation focuses on the crack itself rather than a recent traumatic event.
Turn dental trauma treatment visitors into qualified patients
Give every dental trauma treatment visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.