Dental Form Customization
$99.99
We design and build one custom patient form in Intake Dental / Dental Forms Pro—fully branded, mobile-ready, HIPAA-minded, with conditional logic, e-signature, and auto-routing. Includes QA and 1 revision after delivery.
Description
What you get
- One fully customized form in Intake Dental / Dental Forms Pro (e.g., New Patient Intake, Medical History, Consent, or Specialty form)
- Branding: colors, logo, typography, field styling to match your site
- Smart fields & conditional logic (show/hide sections, required/optional rules)
- Digital signature & date capture with validation
- Notifications & routing (to practice email(s) or team inbox); optional webhook/CRM hook if supported
- Mobile-first UX, accessibility-minded labels and errors, and anti-spam hardening
- Confirmation page/message + optional patient email receipt
- Quality check on live site + 1 round of revisions (text/logic/layout) within 14 days
Ideal for
Solo practices or single-location groups that need one high-quality, branded form without the hassle of building it themselves.
Requirements
- WordPress admin access (Editor+), and an active Intake Dental / Dental Forms Pro installation
- Your logo, brand colors, and list of fields/questions (or a copy/photo of your current paper/PDF form)
- Notification targets (email(s)) and any special routing rules
Process
- We map your paper/PDF fields and confirm any conditional logic
- Build & brand the form on your site or staging
- QA on desktop & mobile, then publish
- One revision round included (copy/logic tweaks)
Notes & limits
- Includes up to ~60 fields and standard conditional logic. Extra-large forms or specialty logic can be added as an add-on.
- HIPAA-aligned features (encryption, access controls) rely on your hosting and plugin configuration; this service does not constitute legal compliance advice.
- Does not include custom payment gateway development, 3rd-party subscription fees, or translation into additional languages (available as add-ons).
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