Know which child orthodontic evaluation leads are worth consultation
Every child orthodontic evaluation enquiry captures the child's age, the specific bite concerns a parent has noticed, and whether a dentist already recommended treatment — plus a smile photo — before it lands in your CRM as a scored, consultation-ready lead.
The exact intake your child orthodontic evaluation leads complete
This is the real 6-question guided intake for Child Orthodontic Evaluation — the same flow your customers finish before you ever pick up the phone.
What a qualified child orthodontic evaluation lead should tell you
A first-look screening of a child's teeth, jaw, and bite to flag alignment issues such as crowding, crossbite, or speech-affecting problems, and to decide whether treatment should start now or be monitored.
- Child'S Age
- Concerns Have Noticed With
- Dentist Or Orthodontist Previously
- Child Had Any Prior
- Was Child'S Last Dental
- Parent Or Legal Guardian
The questions your team needs answered
Every child orthodontic evaluation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What is your child's age? | The age bracket signals which screening window the child falls into, which shapes how soon a consultation slot should be offered. |
| Which concerns have you noticed with your child's teeth or bite? | Structural concerns like crossbite or crowding carry more scoring weight than a routine checkup, helping staff prioritize cases most likely to need active treatment. |
| Has a dentist or orthodontist previously recommended an evaluation? | A prior dentist recommendation is weighted higher because it signals a professional already identified a likely need, making the lead more likely to convert to treatment. |
| Has your child had any prior orthodontic treatment, such as braces or a retainer? | Knowing whether the child previously wore braces or a retainer helps staff distinguish a first-time evaluation from a relapse or follow-up case before booking. |
| When was your child's last dental checkup? | How recently the child saw a dentist indicates whether existing dental records are current enough to inform the evaluation or whether a fresh checkup is needed first. |
| Are you the parent or legal guardian scheduling this evaluation for the child? | Confirming the parent or legal guardian is scheduling directly affects consent and weighs the lead differently than a third party submitting on the family's behalf. |
How Cliont scores child orthodontic evaluation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Under 6
- 6 to 9 years
- 10 to 12 years
- 13 years or older
- Crowding or spacing issues
- Crossbite, overbite, or underbite
See the lead your team receives
Child Orthodontic Evaluation 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 child orthodontic evaluation workflows
| Cliont capability | Child Orthodontic Evaluation application |
|---|---|
| Weighted scoring engine | Age brackets and bite-concern selections (crowding, crossbite, overbite, underbite) are weighted so cases matching common screening windows and structural concerns rise above general checkup requests. |
| Referral-source flagging | A yes answer on the dentist-recommendation question is scored higher and can be tagged in your CRM so referred evaluations are easy to separate from self-initiated enquiries. |
| Guardian verification field | The parent/legal guardian question is captured as a distinct data point so staff can confirm consent status before confirming chair time for someone other than the guardian. |
| Treatment history capture | The prior braces or retainer question lets your team route returning patients differently from first-time evaluations without a separate intake form. |
Common child orthodontic evaluation lead scenarios
Dentist-referred crossbite case
A parent of a 10-12 year old reports a crossbite and mentions their dentist already recommended an evaluation — the intake flags both the age bracket and the referral as high-value signals.
General checkup, no concern noted
A parent selects 'no specific concern, just a checkup' with no bite issue flagged — the intake still records age and checkup history but doesn't inflate urgency it can't support.
Grandparent scheduling the visit
Someone other than the parent or legal guardian submits the form, which the intake captures directly so front-desk staff know to confirm consent before booking chair time.
Teen with prior braces history
A 13+ year old who previously had braces or a retainer comes in through the same form — prior treatment history is captured separately so staff can distinguish relapse cases from first-time evaluations.
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 orthodontics intake templates
Child Orthodontic Evaluation lead-intake FAQs
Does the intake tell us if another dentist already recommended this evaluation?
Yes — the form asks whether a dentist or orthodontist previously recommended an evaluation, and a 'yes' answer carries more scoring weight than a self-initiated enquiry, so referred cases surface as stronger leads.
What happens if a grandparent or babysitter fills out the form instead of the parent?
The intake directly asks whether the person scheduling is the parent or legal guardian, and answers are weighted differently so your front desk can confirm consent before confirming a consultation.
How does the intake handle parents who just want a general checkup with no specific concern?
'No specific concern, just a checkup' is one of the listed options under the bite and teeth concerns question, so those leads are still captured and scored rather than dropped or misclassified as urgent.
Can the intake tell us if a child already had braces or a retainer?
Yes — there's a dedicated yes/no question on prior orthodontic treatment, which helps your team separate first-time evaluations from children who may need follow-up or relapse care.
Does the form ask when the child last saw a dentist?
Yes, the intake includes a single-choice question on the timing of the child's last dental checkup, ranging from within six months to 'not sure,' which helps you gauge how current their dental records are.
How does the child's age affect lead scoring?
Age is asked as a single-choice field with four brackets, and every bracket from under 6 through 13-plus is treated as a high-value signal, since orthodontic screening windows vary by age and stage of dental development.
Turn child orthodontic evaluation visitors into qualified patients
Give every child orthodontic evaluation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.