Turn new patient exam enquiries into consultation-ready leads
Ask new patients about current symptoms, last checkup timing, and insurance coverage before they land on your schedule, and let them upload existing x-rays or dental records so your team walks in prepared.
The exact intake your new patient dental exam leads complete
This is the real 6-question guided intake for New Patient Dental Exam — the same flow your customers finish before you ever pick up the phone.
What a qualified new patient dental exam lead should tell you
A first-time evaluation for a patient establishing care with a new dentist, covering current symptoms, checkup history, and whether prior records or insurance apply before chair time is booked.
- This Exam
- Have Any Tooth Pain,
- Long Has It Been
- Have Dental Insurance Plan
- Have Any Dental Records
- Soon Schedule This Exam
The questions your team needs answered
Every new patient dental exam intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Who is this exam for? | Knowing whether the exam is for the patient, a child, or another adult lets your team route the lead and prepare the right kind of chair time. |
| Do you currently have any tooth pain, swelling, or other dental symptoms? | Current symptoms like pain or swelling are among the highest-weighted signals, marking a lead that may need attention sooner than a standard first visit. |
| How long has it been since your last dental checkup? | How long it's been since their last checkup indicates how much history-taking and clinical time the exam will likely require. |
| Do you have dental insurance you plan to use for this visit? | Insurance status lets front desk verify coverage ahead of the visit rather than discovering it at check-in. |
| Do you have any dental records or x-rays from a previous dentist? | Existing dental records or x-rays let your team skip redundant imaging and prepare for the exam faster. |
| How soon are you hoping to schedule this exam? | Scheduling urgency carries the heaviest weight in this catalog, making it the clearest signal for whether a lead needs a same-day slot instead of routine booking. |
How Cliont scores new patient dental exam leads
Every answer is weighted automatically — no manual review required.
Value signals
- Have Any Tooth Pain,: yes
- As soon as possible
- Within this month
- No rush, flexible timing
See the lead your team receives
New Patient Dental Exam 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 new patient dental exam workflows
| Cliont capability | New Patient Dental Exam application |
|---|---|
| Weighted scoring logic | Combines the symptoms answer with scheduling urgency so a patient reporting pain and wanting to be seen 'as soon as possible' scores well above a symptom-free, flexible-timing enquiry. |
| Document upload widget | Collects existing x-rays or dental records from a previous dentist during intake, so your team can review history before the exam instead of at check-in. |
| Relationship-based routing | Flags whether the exam is for the patient, their child, or another adult they care for, helping front desk staff route pediatric or dependent bookings appropriately. |
| Insurance capture field | Records whether the patient plans to use dental insurance for the visit, letting staff confirm coverage before chair time is confirmed. |
Common new patient dental exam lead scenarios
Symptomatic patient wanting fast care
Reports tooth pain or swelling and selects 'as soon as possible' for scheduling, so the intake flags this as a higher-priority lead that may need a sooner slot than a routine first visit.
Flexible checkup for a child
A parent books on behalf of their child, hasn't been in more than a year, and has no rush on timing, giving the front desk a low-pressure booking they can slot into open chair time.
Never seen a dentist before
Selects 'never had a dental checkup' with no x-rays or prior records available, alerting your team that this visit will likely need extra time for full history and imaging.
Caregiver booking for another adult
Books the exam for another adult they care for, already has insurance and prior x-rays ready to upload, and is fine with a within-the-month timeline rather than urgent 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 general dentistry intake templates
New Patient Dental Exam lead-intake FAQs
How does the intake separate a routine new-patient exam from a pain-driven visit?
The symptoms question and the scheduling urgency question are the two heaviest-weighted fields in this catalog, so a patient reporting pain or swelling who also wants to be seen as soon as possible surfaces well above a flexible, symptom-free booking.
Can the intake tell me if someone is booking for themselves or a dependent?
Yes, the first question asks whether the exam is for the patient, their child, or another adult they care for, so your front desk knows how to route or prepare the appointment before it's confirmed.
What happens if a new patient has never seen a dentist before?
That option is built into the checkup-history question, so your team gets advance notice that the exam may need extra time for full history-taking rather than a standard recall-style visit.
Does the intake ask about insurance before the appointment?
Yes, patients confirm whether they plan to use dental insurance for the visit, which lets your team verify coverage ahead of time instead of discovering it at check-in.
Can patients upload x-rays or records from a previous dentist?
Yes, the intake asks if they have existing dental records or x-rays and lets them attach them directly, which can reduce redundant imaging at the first visit.
How is this different from the intake for Routine Dental Cleaning or Dental X-Rays?
This catalog is built around establishing a new patient's baseline history and current symptoms, while Routine Dental Cleaning and Dental X-Rays intakes focus on maintenance timing and imaging needs for existing patients.
Turn new patient dental exam visitors into qualified patients
Give every new patient dental exam visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.