Root canal intake that captures pain level and swelling up front
Patients report tooth pain, swelling, and how long symptoms have lasted before they ever reach your chair, and upload a photo of the affected area so your team can gauge urgency at a glance.
The exact intake your root canal consultation leads complete
This is the real 6-question guided intake for Root Canal Consultation — the same flow your customers finish before you ever pick up the phone.
What a qualified root canal consultation lead should tell you
A scheduling-stage intake that gathers a patient's tooth pain, swelling, and symptom history so an endodontic practice can judge how urgently a consultation is needed before chair time is booked.
- Experiencing Tooth Pain Or
- Noticed Any Swelling Or
- Would Describe Pain Level
- Dentist Previously Recommended Root
- Long Have Had Symptoms
- This Consultation Yourself Or
The questions your team needs answered
Every root canal consultation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Are you currently experiencing tooth pain or sensitivity? | Active tooth pain or sensitivity is the strongest single signal that a root canal consultation is needed soon rather than something the patient is just researching. |
| Have you noticed any swelling or a bump near the affected tooth? | Swelling or a bump can indicate an abscess or spreading infection, so a 'yes' answer pushes the lead toward prompt follow-up regardless of how the patient rates their pain. |
| How would you describe the pain level in the affected tooth? | Severe or moderate pain levels weight the lead far higher than mild discomfort, helping staff decide who needs the next available appointment slot. |
| Has a dentist previously recommended a root canal for this tooth? | A prior root canal recommendation from another dentist means the patient is already pre-diagnosed and closer to committing, not just gathering information. |
| How long have you had symptoms with this tooth? | Segments the lead so you can route, price, and prioritize it correctly. |
| Is this consultation for yourself or for a child or dependent? | Flagging whether the consultation is for the adult booking it or a child or dependent lets front-desk staff prepare the correct consent and communication approach ahead of the visit. |
How Cliont scores root canal consultation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Experiencing Tooth Pain Or: yes
- Noticed Any Swelling Or: yes
- Mild
- Moderate
- Dentist Previously Recommended Root: yes
Urgency signals
- Severe
See the lead your team receives
Root Canal Consultation 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 root canal consultation workflows
| Cliont capability | Root Canal Consultation application |
|---|---|
| Weighted scoring engine | Ranks a patient reporting severe pain and swelling above one reporting only mild sensitivity, so your team calls back the higher-risk case first. |
| Photo upload capture | Collects a photo of visible swelling or the affected tooth before the consultation, giving your team a visual reference alongside the symptom answers. |
| Video intake widget | Lets patients show swelling or point to the painful area on camera, adding context beyond what a single_choice pain-level answer can convey. |
| CRM routing | Sends qualified consultation leads to your CRM with pain level, swelling status, and prior-recommendation answers attached, so staff can triage without re-asking the patient. |
| Dependent-aware intake flow | Uses the self vs. child/dependent answer to flag records that need parental consent handling before the consultation is confirmed. |
Common root canal consultation lead scenarios
Severe pain with visible swelling
The patient reports severe pain plus a swelling or bump near the tooth, a combination the intake weights heavily so it surfaces as a high-priority lead for your team.
Mild ache, no prior diagnosis
Symptoms are recent and mild with no swelling and no prior root canal recommendation, so the lead still qualifies but ranks lower than urgent cases needing immediate chair time.
Consultation booked for a child
The intake records that the consultation is for a dependent rather than the adult filling out the form, so front-desk staff can prepare age-appropriate consent and expectations before the visit.
Swelling without noticeable pain
A patient reports no pain but does flag swelling near the tooth, an unusual combination that still carries meaningful weight since silent swelling can indicate infection.
Symptoms lingering over a month
Pain has persisted for weeks with no prior dentist recommendation, giving your team context on chronicity even though duration itself isn't a scored field.
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
Root Canal Consultation lead-intake FAQs
How does the intake decide which root canal consultation leads are high priority?
Answers to tooth pain, swelling, pain severity, and whether a dentist already recommended a root canal carry the most weight, so a patient reporting severe pain with swelling scores well above one reporting mild sensitivity alone.
What happens if a patient says they have swelling but no pain?
Swelling is weighted heavily on its own because it can signal an active infection even without pain, so that lead is still flagged for prompt attention rather than filed as low-priority.
Can the intake tell us when a consultation is for a child instead of the adult filling out the form?
Yes, the intake asks whether the visit is for the patient themselves or a child or dependent, which lets your front desk prepare the right paperwork and set expectations before the appointment.
What should patients upload before their root canal consultation?
Patients can upload a photo of the swollen area or visible issue and, if they have one, a recent dental X-ray from a prior visit, giving your team visual context before the appointment.
Does asking how long symptoms have lasted affect the lead's score?
Symptom duration doesn't carry a scoring weight on its own, but it's captured alongside pain and swelling answers so your team has fuller context for triage when reviewing the lead.
Turn root canal consultation visitors into qualified patients
Give every root canal consultation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.