---
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: "2026-03-28T00:44:41.910Z"
---

[← 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.
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