Root canal intake that captures symptom severity up front
Patients tell you their symptom severity, which tooth is affected, and how soon they need to be seen, while Cliont collects any existing X-rays before the case lands in your CRM.
The exact intake your root canal treatment leads complete
This is the real 5-question guided intake for Root Canal Treatment — the same flow your customers finish before you ever pick up the phone.
What a qualified root canal treatment lead should tell you
A qualification flow for patients who may need pulp-level treatment on a specific tooth, capturing symptom severity, referral status, and imaging on hand so the practice knows how urgently to seat the patient.
- Dentist Told That May
- Best Describes Current Symptoms
- Have Any Recent Dental
- Tooth Or Area Affected
- Soon Be Seen
The questions your team needs answered
Every root canal treatment intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Has a dentist told you that you may need a root canal? | A prior dentist recommendation confirms the patient already understands they likely need treatment, making the lead more likely to convert to a booked consultation. |
| Which best describes your current symptoms? | Symptom severity is the strongest single indicator of clinical urgency and directly separates same-day cases from routine ones. |
| Do you have any recent dental X-rays of the affected tooth? | Knowing whether X-rays already exist tells the practice whether imaging needs to happen before or during the first visit. |
| Which tooth or area is affected? | Tooth location gives staff a starting reference for scheduling and provider assignment before any conversation happens. |
| How soon are you looking to be seen? | Stated timeframe shows how much scheduling pressure the patient is under, which is what determines whether chair time should be held immediately. |
How Cliont scores root canal treatment leads
Every answer is weighted automatically — no manual review required.
Value signals
- Dentist Told That May: yes
- Mild or occasional pain
- Sensitivity to hot or cold only
- Within a few days
- Within a few weeks
Urgency signals
- Severe pain or swelling
- Emergency, as soon as possible
See the lead your team receives
Root Canal 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 root canal treatment workflows
| Cliont capability | Root Canal Treatment application |
|---|---|
| Weighted scoring engine | Combines the symptom severity answer with the urgency timeline answer into a single priority score, so severe pain paired with 'emergency' consistently outranks mild sensitivity paired with 'just exploring.' |
| Document upload capture | When a patient confirms they have recent X-rays, the intake collects them directly so the images are already in the case file before the first appointment is booked. |
| Conditional field logic | The tooth-location answer (upper/lower, front/back, or not sure) is carried into the CRM record so scheduling can match the case to the right provider or chair time. |
| Real-time CRM sync | Cases where a dentist already recommended a root canal sync to your CRM tagged as referred, keeping them distinct from patients who self-identified symptoms. |
Common root canal treatment lead scenarios
Severe pain, needs same-day care
Patient reports severe pain or swelling and selects 'emergency, as soon as possible' — the intake flags this combination as top priority so the front desk can find same-day chair time.
Dentist-referred, mild symptoms
A general dentist already told the patient they may need a root canal, but pain is only mild — the intake still routes this as a warm, confirmed case even without urgent symptoms.
Sensitivity only, still shopping
Patient has hot/cold sensitivity and marks 'just exploring options' — this pairing scores lower on urgency, letting staff nurture the lead instead of holding an appointment slot.
No X-rays, unsure which tooth
Patient hasn't had recent X-rays and doesn't know which tooth is affected — the intake still captures symptoms and timing so staff can plan an imaging visit before treatment 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
Root Canal Treatment lead-intake FAQs
How does the intake prioritize a patient in severe pain?
When a patient selects severe pain or swelling and needs to be seen as soon as possible, those two answers combine into a high urgency score so the case surfaces ahead of routine inquiries in your CRM.
What happens if a patient doesn't have X-rays yet?
The intake still asks about symptoms, tooth location, and timing even when the patient answers no to having recent X-rays, so your team knows to schedule imaging as part of the first visit rather than losing the lead.
Can I tell which leads were already referred by another dentist?
Yes — the intake asks directly whether a dentist has told the patient they may need a root canal, and that answer is passed through so referred patients are visible as a distinct group from self-diagnosed inquiries.
Does the intake tell us which tooth is involved before we call back?
Patients select the general area — upper or lower, front or back teeth, or 'not sure' — so your team has a starting point for scheduling even before the first conversation.
How do we avoid holding chair time for patients who are just browsing?
Patients who choose 'just exploring options' for timing score lower than those needing to be seen within days, which helps you separate cases worth a consultation slot from ones better handled with a follow-up call.
Turn root canal treatment visitors into qualified patients
Give every root canal treatment visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.