--- title: Orthodontic Treatment Intake Form Template | Paperform description: Professional orthodontic intake form for braces and aligner consultations. Capture medical history, bite analysis, smile goals, insurance details, and payment preferences in one streamlined form. url: "https://paperform.co/templates/orthodontic-treatment-intake-form" type: static generatedAt: "2026-04-04T00:44:46.436Z" --- [← Back to free form templates](/templates/) ![Orthodontic Treatment Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/orthodontic-treatment-intake-form.png) [Preview](https://_preview.paperform.co/ai-template/orthodontic-treatment-intake-form) [Use this template for free](/create?ai-template=orthodontic-treatment-intake-form) [Application Forms](/templates/category/applications/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Dental](/templates/industry/dental/) [Dentist](/templates/role/dentist/)[Healthcare Administrator](/templates/role/healthcare-admin/) About this free form template ### Streamline Your Orthodontic Practice with a Professional Intake Form Starting orthodontic treatment is a significant commitment for patients and their families. This **Orthodontic Treatment Intake Form** helps your practice gather essential information upfront—from medical and dental history to smile goals and payment preferences—creating a smooth, professional experience from the first consultation. Built specifically for orthodontists and dental practices offering braces, clear aligners, and corrective treatments, this template captures everything you need to assess candidacy, understand patient expectations, and discuss treatment timelines and costs. By collecting detailed information before the appointment, you can spend more chair time on examination and less on paperwork. #### Perfect for orthodontic and specialty dental practices Whether you're an established orthodontic practice or a general dentist expanding into cosmetic and corrective care, this form helps you: - **Assess bite and alignment issues** with structured questions about current concerns, previous dental work, and functional challenges - **Understand aesthetic goals** so you can align treatment recommendations with what matters most to your patients - **Discuss payment options upfront** with built-in fields for insurance information and flexible payment plan preferences - **Set realistic expectations** by capturing patients' availability, commitment level, and timeline preferences #### Built on Paperform—designed for healthcare workflows With Paperform's conditional logic, you can show or hide questions based on patient age, insurance status, or treatment preferences, keeping the form relevant and concise. Embed the form on your practice website, share it via email after booking consultations, or display it on tablets in your waiting room. Submissions automatically flow into your practice management system via integrations with tools like Google Sheets, Airtable, or your CRM, and you can trigger follow-up emails, appointment reminders, or payment links through **[Stepper](https://stepper.io)**—Paperform's AI-native workflow builder. If you need patients to sign treatment consent forms or financial agreements, **[Papersign](https://papersign.com)** lets you send eSignature requests directly from the intake submission. Paperform is **SOC 2 Type II compliant** and offers robust data security controls, so you can confidently collect sensitive health information while meeting privacy standards. With custom branding, mobile-friendly design, and clear multi-page layouts, your intake forms can feel as polished and professional as your practice. #### Save time, improve patient experience, start treatment faster By digitizing orthodontic intake with Paperform, you reduce no-shows, minimize administrative burden, and walk into every consultation fully prepared. Patients appreciate the clarity and convenience, and your team gets back valuable time to focus on care, not paperwork. Built for growing businesses, trusted by bigger ones. Trusted by 500K+ business owners and creators, and hundreds of millions of respondents. ![Capterra - 4.8 out of 5](/images/capterra-st.jpg) ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg) ![G2 - 4.8 out of 5](/images/g2-st.jpg) [Try Paperform free now](/register) ## More templates like this [![All-on-4 Dental Implant Consultation Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/all-on-4-dental-implant-consultation-form.png) ### All-on-4 Dental Implant Consultation Form Comprehensive consultation form for All-on-4 dental implant procedures, including full arch assessment, medical history evaluation, and surgical planning for full mouth restoration.](/templates/all-on-4-dental-implant-consultation-form/) [![Cleft Lip and Palate Team Evaluation Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cleft-lip-and-palate-team-evaluation-form.png) ### Cleft Lip and Palate Team Evaluation Form A comprehensive telehealth evaluation form for cleft lip and palate patients, enabling multidisciplinary team assessment with speech recordings, orthodontic photos, feeding evaluations, and surgical revision planning.](/templates/cleft-lip-and-palate-team-evaluation-form/) [![Dental Emergency Walk-In Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dental-emergency-walk-in-form.png) ### Dental Emergency Walk-In Form Streamline emergency dental visits with this walk-in form that captures patient details, triages chief complaints, assesses pain levels, and determines same-day treatment needs efficiently.](/templates/dental-emergency-walk-in-form/) [![Dental Implant Consultation Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dental-implant-consultation-form.png) ### Dental Implant Consultation Form A comprehensive dental implant consultation form that includes bone density assessment, detailed medical history review, and 3D imaging consent for implant candidates.](/templates/dental-implant-consultation-form/) [![Dental Intraoral Camera Imaging & Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dental-intraoral-camera-imaging-consent-form.png) ### Dental Intraoral Camera Imaging & Consent Form Streamline intraoral imaging documentation with patient consent, visual education, and insurance support all in one professional form.](/templates/dental-intraoral-camera-imaging-consent-form/) [![Dental School Loan Forgiveness Application - Rural Practice Commitment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dental-school-loan-forgiveness-application-rural-practice-commitment.png) ### Dental School Loan Forgiveness Application - Rural Practice Commitment Apply for dental school loan forgiveness through a rural practice commitment program. 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