Know which retainer replacement leads are worth a consultation
Ask patients about their retainer's condition, whether they completed prior orthodontic treatment, and any tooth shifting before they book — then send only genuine replacement cases straight to your CRM.
The exact intake your retainer replacement leads complete
This is the real 6-question guided intake for Retainer Replacement — the same flow your customers finish before you ever pick up the phone.
What a qualified retainer replacement lead should tell you
Replacing a lost, broken, worn, or ill-fitting retainer for a patient who has already completed orthodontic treatment, where the intake needs to confirm retainer condition, treatment history, and any tooth movement before scheduling.
- Current Condition Retainer
- Previously Complete Orthodontic Treatment
- Retainer Did Last Use
- Noticed Any Shifting In
- Soon Get Replacement Retainer
- This Retainer Replacement
The questions your team needs answered
Every retainer replacement intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What is the current condition of your retainer? | The retainer's current condition determines whether the case is a quick remake or a sign of a more serious fit or relapse issue. |
| Did you previously complete orthodontic treatment with braces or aligners? | Confirming the patient already completed orthodontic treatment tells staff there's an existing treatment record to reference rather than starting a new case. |
| What type of retainer did you last use? | Segments the lead so you can route, price, and prioritize it correctly. |
| Have you noticed any shifting in your teeth since losing or breaking the retainer? | Reported tooth shifting since losing the retainer signals possible relapse, which may require more than a simple remake. |
| How soon are you hoping to get a replacement retainer? | The requested timeline helps staff decide how quickly to schedule the patient in relative to other retainer requests. |
| Who is this retainer replacement for? | Knowing whether the retainer is for the patient, a minor, or another dependent affects consent requirements and who to contact for scheduling. |
How Cliont scores retainer replacement leads
Every answer is weighted automatically — no manual review required.
Value signals
- Lost
- No longer fits properly
- Worn out from regular use
- Previously Complete Orthodontic Treatment: yes
- Noticed Any Shifting In: yes
Urgency signals
- Broken or cracked
See the lead your team receives
Retainer Replacement 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 retainer replacement workflows
| Cliont capability | Retainer Replacement application |
|---|---|
| Guided photo capture | Prompts patients to upload a photo of their current retainer so staff can see whether it's broken, cracked, or simply worn before the first call. |
| Conditional branching | Routes leads differently based on whether the retainer replacement is for the patient themselves, a minor child, or another dependent in their care. |
| Lead scoring engine | Weighs prior orthodontic treatment completion and reported tooth shifting together, so relapse-risk cases surface above routine wear-and-tear remakes. |
| CRM sync | Pushes qualified retainer leads into your CRM tagged with retainer type and requested timeline, so front desk staff know what to prep for. |
Common retainer replacement lead scenarios
Lost retainer with visible shifting
Patient reports a lost retainer and confirms teeth have moved since — the intake flags this as a higher-value lead needing a fuller evaluation, not just a remake.
Broken fixed retainer, past treatment complete
A bonded retainer has cracked and the patient confirms they finished braces or aligners previously, giving your team treatment history before the first call.
Worn-out retainer, no urgency
Retainer is simply worn from years of use, no shifting noted, and the patient selects no specific timeline — a straightforward remake with lower priority scheduling.
Parent booking for a minor child
A parent submits the intake on behalf of a dependent, so the lead routes with dependent contact details flagged for consent and scheduling around school hours.
Retainer no longer fits, type unclear
Patient isn't sure what type of retainer they last wore and reports it no longer fits — the intake still captures condition and history so staff aren't starting from zero.
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
Retainer Replacement lead-intake FAQs
How does the intake separate a simple remake from a case that needs a fuller evaluation?
Answers about retainer condition combined with whether the patient has noticed tooth shifting are weighted together, so a lost retainer with no movement scores differently than one where shifting has already started.
Does the intake work for both adult patients and parents booking for a child?
Yes — the intake asks who the retainer replacement is for, so leads submitted for a minor or other dependent are flagged separately from self-bookings.
Can the intake tell us what kind of retainer the patient was using?
Patients select whether their last retainer was removable clear plastic, removable with wire, fixed/bonded, or unknown, which helps your team anticipate chair time and materials before the appointment.
How does the requested timeline affect lead priority?
Patients choose from as soon as possible, within a few weeks, or no specific timeline, and this feeds into how the lead is scored and where it lands in your CRM's queue.
Is this intake different from the one used for Adult Orthodontics or Clear Aligners?
Yes — retainer replacement uses its own catalog focused on retainer condition and prior treatment history rather than new-treatment questions, so it won't ask patients about aligner or braces candidacy.
What happens if a patient reports significant tooth shifting?
A yes answer on shifting is one of the higher-weighted signals in this catalog, so those leads are scored to stand out from routine remake requests.
Turn retainer replacement visitors into qualified patients
Give every retainer replacement visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.