Know which gum graft leads are worth consultation time
Ask about diagnosed gum recession, current symptoms like tooth sensitivity or visible root exposure, and how many teeth are affected — then have patients upload photos before a chair slot is ever booked.
The exact intake your gum graft leads complete
This is the real 6-question guided intake for Gum Graft — the same flow your customers finish before you ever pick up the phone.
What a qualified gum graft lead should tell you
A periodontal procedure that adds soft tissue to areas of gum recession to cover exposed tooth roots, typically evaluated by number of teeth affected and severity of exposure.
- Dentist Or Periodontist Told
- Symptoms Noticing In Affected
- Many Teeth Or Areas
- Previously Had Any Gum
- Have Dentist Or Periodontist
- Soon Would Like Move
The questions your team needs answered
Every gum graft intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Has a dentist or periodontist told you that you have gum recession? | A prior professional diagnosis of gum recession confirms clinical need rather than patient assumption, which is why it carries the heaviest weight in the catalog. |
| What symptoms are you noticing in the affected area? | Visible tooth root and tooth sensitivity indicate more advanced recession than 'no noticeable symptoms,' letting the score reflect real severity. |
| How many teeth or areas are affected? | Knowing whether one tooth or many teeth are affected helps the practice anticipate the scope and complexity of the consultation before it's booked. |
| Have you previously had any gum treatment or surgery in this area? | A history of prior gum treatment in the same area changes the clinical conversation from a first-time graft to a possible revision case. |
| Do you currently have a dentist or periodontist you see regularly? | Separates real opportunities from leads that aren’t a fit yet. |
| How soon would you like to move forward with treatment? | Patients ready to move forward immediately are worth prioritizing for chair time over those who are still just exploring options. |
How Cliont scores gum graft leads
Every answer is weighted automatically — no manual review required.
Value signals
- Dentist Or Periodontist Told: yes
- Tooth sensitivity
- Visible tooth root
- Teeth look longer than before
- Discomfort when brushing
- No noticeable symptoms
See the lead your team receives
Gum Graft 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 gum graft workflows
| Cliont capability | Gum Graft application |
|---|---|
| Photo upload widget | Collects close-up images of the exposed root or gum line so your team can visually confirm severity before the patient is on the schedule. |
| Weighted scoring engine | Combines the diagnosed-recession answer with selected symptoms like visible tooth root or sensitivity to separate confirmed clinical cases from patients still guessing. |
| Multi-choice symptom capture | Flags combinations such as visible root exposure plus brushing discomfort as higher-value leads compared to a patient who reports no noticeable symptoms. |
| Timeline segmentation | Separates 'as soon as possible' patients from 'just exploring' ones so chair time isn't held for consultations that are still months out. |
Common gum graft lead scenarios
Diagnosed recession, ready now
A patient already told by a dentist they have gum recession, with visible root exposure and wanting to move as soon as possible — this combination scores as a top-priority lead.
Widespread recession, still exploring
Many teeth affected but the patient selects 'just exploring options' on timeline — the intake still flags the clinical severity while signaling this consultation may need more education than urgency.
Single tooth, no clear symptoms
One tooth affected, no prior diagnosis, and 'no noticeable symptoms' selected — a lower-intensity case the front desk can still triage without assuming urgency.
Previous graft, second opinion
A patient who has already had gum treatment or surgery in the same area is a different clinical conversation than a first-time case, and the intake surfaces that history before the visit.
No regular provider, cosmetic concern
Teeth appearing longer and discomfort while brushing, but no established periodontist on file — the intake captures both the symptom profile and the referral gap in one pass.
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 periodontics intake templates
Gum Graft lead-intake FAQs
Can the intake tell the difference between a diagnosed case and a patient who just suspects recession?
Yes — the question asking whether a dentist or periodontist has already told the patient they have gum recession carries more weight than a self-suspected case, so confirmed diagnoses surface higher in your queue.
Does the form separate single-tooth cases from widespread recession?
The intake asks how many teeth or areas are affected, from one tooth to widespread recession, so your team can see case scope before deciding how much chair time and material a consultation might need.
How does the treatment timeline answer affect where a lead lands?
A patient selecting 'as soon as possible' scores differently than one who is 'just exploring options,' which helps you avoid booking chair time for leads that are months away from deciding.
What if a patient already had gum surgery in the same spot?
The intake asks about prior gum treatment or surgery in the affected area, so your team walks into the consultation knowing whether this is a new site or a revision case.
Does the intake capture symptom detail beyond a simple yes or no?
It asks patients to select from specific symptoms like tooth sensitivity, visible tooth root, teeth appearing longer, or discomfort when brushing, giving your team a clinical picture, not just a general complaint.
How are patients without a regular periodontist handled?
The intake asks whether the patient currently sees a dentist or periodontist regularly, which helps you flag self-referred patients who may need more context gathered before their first visit.
Turn gum graft visitors into qualified patients
Give every gum graft visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.