Dental Intraoral Camera Imaging & Consent Form

Simplify Dental Imaging Documentation with Paperform

Intraoral cameras have revolutionized patient education and treatment planning in modern dentistry, but managing the consent, documentation, and insurance paperwork can still feel overwhelming. This Dental Intraoral Camera Imaging & Consent Form brings everything together in one streamlined, professional workflow—saving your team time while improving patient understanding and compliance.

Whether you're a general dentist, orthodontist, periodontist, or oral surgeon, this template helps you capture informed consent, document clinical findings with visual references, and support insurance claims with the proper authorization—all before the camera even enters the patient's mouth.

Why Paperform for Dental Imaging Documentation?

Dental practices need forms that feel modern, professional, and easy for patients to complete—whether they're filling them out in the waiting room on a tablet or at home before their appointment. Paperform's clean, on-brand design makes clinical forms feel less intimidating, while powerful conditional logic ensures patients only see the questions relevant to their situation.

With built-in eSignature capabilities through Papersign, you can collect legally binding consent without printing a single sheet. Patients sign digitally, you get instant notification, and everything is stored securely with a complete audit trail—perfect for compliance and insurance documentation.

What This Template Includes

This comprehensive template covers every aspect of intraoral imaging documentation:

Patient Information & Dental History: Capture essential demographics, insurance details, and relevant medical/dental history that might impact imaging procedures or interpretation.

Visual Documentation Consent: Clear, plain-language explanation of what intraoral cameras are, how they're used, and what images will be captured. Patients provide informed consent for imaging, storage, and clinical use of their dental photographs.

Insurance Authorization: Built-in section for patients to authorize the use of intraoral images for insurance claims, pre-authorization submissions, and treatment documentation—streamlining your billing workflow.

Patient Education Acknowledgment: Helps patients understand that images will be used to explain their diagnosis, show treatment progress, and support shared decision-making about their care.

Image Usage Permissions: Optional permissions for using de-identified images in case presentations, staff training, or marketing materials (with appropriate patient consent).

Clinical Documentation Fields: Space for dental professionals to note which teeth/areas were imaged, clinical findings observed, and recommended treatment based on visual evidence.

Perfect for Every Dental Specialty

This template adapts beautifully across dental disciplines:

• General Dentistry: Document caries, cracks, wear patterns, and soft tissue lesions
• Orthodontics: Capture bracket placement, tooth movement, and occlusal relationships
• Periodontics: Visualize pocket depths, recession, and tissue health over time
• Endodontics: Image canal access, file placement, and post-treatment healing
• Oral Surgery: Pre-op assessment and post-op healing documentation
• Cosmetic Dentistry: Before/after comparison for veneers, whitening, and smile makeovers

Automate Your Dental Workflow with Stepper

Once a patient submits this form, Stepper (stepper.io) can automatically trigger your entire documentation workflow. Send completed forms and eSignatures directly to your practice management software, create patient records in your dental CRM, notify the clinical team that imaging consent is complete, and even pre-populate insurance claim forms with the necessary authorization.

Stepper connects Paperform to platforms like Dentrix, Eaglesoft, Open Dental, and hundreds of other tools—no coding required. That means less manual data entry, fewer missed authorizations, and more time for patient care.

Compliance, Security & HIPAA Considerations

While Paperform is SOC 2 Type II compliant and offers robust security features including data encryption and access controls, it's important to note that Paperform is not HIPAA compliant. Dental practices subject to HIPAA regulations should evaluate whether this solution meets their specific compliance requirements or consider using it for non-PHI workflows.

For practices that can use Paperform, you'll benefit from secure form submissions, role-based access controls, and the ability to export or delete patient data as needed for privacy compliance.

Improve Patient Communication & Case Acceptance

Intraoral cameras increase case acceptance by an average of 30% when patients can see exactly what you see. This form sets the foundation for that visual education by ensuring patients understand how imaging benefits their care, building trust before treatment even begins.

By collecting consent digitally and integrating with your existing practice software via Stepper, you eliminate the "consent hunt" when it's time to submit claims or review treatment plans. Everything is documented, signed, and searchable in one place.

Get Started in Minutes

This template is ready to customize with your practice name, logo, and specific consent language. Adjust the conditional logic to match your imaging protocols, add your practice's colors and fonts to match your brand, and embed the form on your patient portal or website—or send it as a standalone link via email or SMS.

Trusted by dental practices worldwide, this Paperform template helps modern dentists deliver better patient experiences while keeping documentation organized and compliant. Start capturing better consent and supporting stronger insurance claims today.