Crown lengthening intake that captures the referring reason up front
Ask why the tooth needs lengthening, whether a dentist already referred the case, and how many teeth are involved before you commit chair time. Patients upload intraoral photos during intake so you can review the site before the first visit.
Preview your crown lengthening intake
Explore 5 questions from the Crown Lengthening template. This interactive preview uses illustrative scoring and sample attachments. Open the full survey to try the complete intake.
What a qualified crown lengthening lead should tell you
A periodontal procedure that removes excess gum tissue, and sometimes bone, to expose more of a tooth's structure — most often to prepare it for a crown or restoration, correct decay or a fracture below the gumline, or address a tooth that looks too short.
- Main Reason Crown Lengthening
- Dentist Already Recommended Crown
- Many Teeth Involved
- Experiencing Pain, Swelling, Or
- Soon Have This Procedure
The questions your team needs answered
Every crown lengthening intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What is the main reason you need crown lengthening? | Restorative and decay/fracture reasons carry the top weight, letting staff prioritize prep-for-crown cases over purely cosmetic requests. |
| Has a dentist already recommended crown lengthening for this tooth? | A confirmed dentist referral scores higher because the case is already treatment-planned and closer to being consultation-ready than a self-referred inquiry. |
| How many teeth are involved? | This field carries no scoring weight, but it tells staff whether to plan for a single-tooth visit or a multi-tooth/full-arch case before the patient arrives. |
| Are you currently experiencing pain, swelling, or infection near this tooth? | Active pain or swelling scores higher than a symptom-free answer, distinguishing comfort-driven requests from routine restorative prep. |
| How soon are you hoping to have this procedure done? | Timeline isn't weighted in scoring, but it tells the front desk how soon to try to offer an opening on the calendar. |
How Cliont scores crown lengthening leads
Configured answer weights help your team prioritize follow-up. Your team reviews each submission and decides the next step.
Value signals
- Preparing a tooth for a crown or restoration
- Tooth looks too short (cosmetic reasons)
- Decay or fracture extends below the gum line
- Not sure
- Dentist Already Recommended Crown: yes
- Experiencing Pain, Swelling, Or: yes
See an example lead handoff
Illustrative lead details and score show how a submission can reach your team.
Crown Lengthening 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 crown lengthening workflows
| Cliont capability | Crown Lengthening application |
|---|---|
| Branching answer logic | Routes the lead differently depending on whether the patient selects a restorative reason, a cosmetic reason, or decay/fracture below the gumline in the reason-for-treatment question. |
| Referral status capture | Flags whether a dentist has already recommended the procedure, so front-desk staff can skip re-screening a treatment-planned case. |
| Symptom screening | Records current pain, swelling, or infection so staff can weigh scheduling priority against symptom-free, purely cosmetic requests. |
| File uploads during intake | Collects intraoral photos of the tooth and gum line before the consultation, without requiring the patient to email images separately. |
| Weighted lead scoring | Ranks restorative and decay/fracture cases above cosmetic-only inquiries in the CRM, based on the weights attached to the reason-for-treatment answers. |
Example crown lengthening lead scenarios
Illustrative situations explain the intake questions and possible follow-up.
Referred restorative case, single tooth
A dentist has already recommended crown lengthening to prep one tooth for a restoration. The intake flags the confirmed referral and restorative reason, so this consultation stands out as ready to schedule.
Cosmetic gum reshaping inquiry
The patient selects a cosmetic reason with no dentist referral yet and is just exploring options. The intake still captures the case but signals it may need more education before booking chair time.
Decay below the gumline with active pain
Decay or fracture extending below the gum is combined with current pain or swelling. Both answers carry higher weight, so this lead surfaces with a stronger score for prompt follow-up.
Unsure reason, multiple teeth involved
The patient isn't certain why lengthening was suggested and several teeth or a full arch may be affected. The intake still records the case detail so staff can clarify scope before the consultation instead of guessing from a phone message.
Connect Cliont to your workflow
Connect your CRM
HubSpot, HighLevel, monday.com
Connect your legal software
Lawmatics, MyCase, Clio Manage and Clio Grow
Notify your team
Email, SMS, Slack
Configure other destinations
Google Sheets, configured webhooks, Zapier and API workflows
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 periodontics intake templates
Crown Lengthening lead-intake FAQs
How does the intake separate cosmetic requests from restorative ones?
The reason-for-treatment question distinguishes preparing a tooth for a crown or a decay/fracture case — both weighted higher — from a purely cosmetic request, so restorative-driven cases are easier to spot in the CRM.
Does it matter if the patient hasn't seen their general dentist yet?
Yes — a confirmed dentist referral carries more weight than a self-referred case, since a referred patient is usually already treatment-planned and closer to being ready for a consultation.
What happens if a patient reports pain or swelling near the tooth?
That answer carries a higher weight than a symptom-free response, which raises the lead's score so staff can decide whether to offer an earlier opening rather than treating it as a routine cosmetic inquiry.
Can the intake tell me if a case involves more than one tooth?
Yes — the intake records whether the case involves one tooth, a few teeth, or a full arch, which helps you gauge scope before the consultation even though this question doesn't add to the lead score.
Is crown lengthening intake different from your gum graft or gum disease treatment intakes?
Each subservice, including Gum Graft and Gum Disease Treatment, runs its own qualification questions tailored to that procedure — crown lengthening focuses on the restorative or cosmetic reason, referral status, and tooth count rather than pocket depth or tissue recession.
What if a patient selects 'not sure' when asked why they need the procedure?
It's still recorded as a valid lead rather than discarded, so staff can use the consultation to clarify the reason instead of losing the inquiry to an unanswered question.
Turn crown lengthening visitors into qualified patients
Give every crown lengthening visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.