Get 3 Months Free
HIPAA-Compliant Patient Intake Forms That Save Time
Solo Practice tier only • Credit card required but not charged for 3 months
Stop Wasting Staff Time on Paper Forms
California practices are saving 10+ hours per week with digital intake
Live in 60 Seconds
We auto-provision your secure subdomain at signup. No setup, no IT required.
Save $100-$600/Month
Only $199.99/mo vs $300-$800 competitors charge. No contracts, cancel anytime.
Fully HIPAA Compliant
AES-256 encryption, AWS S3 storage, automatic BAA included.
Everything You Need, Nothing You Don't
Complete Patient Intake Forms
Medical history, insurance uploads, emergency contacts, HIPAA consent
Auto Doctor E-Signatures
Consent forms automatically signed and emailed as PDFs to office & patient
Secure AWS S3 Storage
Bank-level encryption at rest and in transit with automatic backups
Analytics Dashboard
Track submissions, completion rates, and patient engagement
Mobile Responsive
Patients fill forms on any device - phone, tablet, or desktop
Works With Every PMS
Dentrix, Eaglesoft, Open Dental, Curve, and all others - no integration needed
Auto Email of PDF Forms
Completed forms automatically sent to your office email as PDFs
Expedited Health History Updates
Patients complete health history updates in seconds - not minutes
No Training Required
Intuitive interface - your team will understand it immediately
30-Day Money Back Guarantee
Try it risk-free. Not happy? Get a full refund, no questions asked
Stop Overpaying for Complicated Systems
❌ What Others Force You To Do
- Sign 2-3 year contracts
- Switch your phone system
- Pay $300-$800/month
- Wait weeks for implementation
- Deal with complex integrations
- Train staff on new systems
- Pay upfront setup fees
✓ Intake Dental Difference
- No contracts - monthly billing
- Keep your current phone system
- Only $199.99/month
- Live in 60 seconds
- Zero setup - works immediately
- Intuitive - minimal training needed
- No setup fees - ever
All Forms Included
Patient Intake Forms
- Complete medical history
- Insurance card upload
- Emergency contacts
- HIPAA consent
- Demographics
Consent Forms
- Treatment consent
- Photo/video release
- Financial agreements
- Doctor e-signatures
- Expiring links
Appointment Forms
- New patient booking
- Existing patient updates
- Health history updates
- Auto-populate data
- Mobile responsive
Claim Your 3 Free Months
For your first 3 months
Enter promo code at signup • Save $599.97
Solo Practice tier only • Join 500+ practices already using Intake Dental
Trusted by 500+ Dental Practices
"Setup took literally 60 seconds. Our patients love filling forms on their phone before they arrive."
"We were paying $450/month for a system that required a 3-year contract. Intake Dental does everything we need for less than half the price."
"HIPAA compliance was a nightmare until we found this. The BAA is included and everything is encrypted. Finally peace of mind."
Frequently Asked Questions
How do I get my 3 free months?
Sign up at intake.dental/signup and enter your promo code during registration. Your credit card will be saved but not charged for the first 3 months. That's a total savings of $599.97!
Why do you need my credit card if it's free for 3 months?
We require a credit card on file but won't charge it for 3 months. This prevents abuse of the free offer and ensures a seamless transition after your promotional period. You can cancel anytime before the 3 months end with no charge.
Do I need to integrate with my practice management software?
No! That's the beauty of Intake Dental. Patients fill out forms, you get a PDF emailed to your office. Simply upload to your PMS like you would any other document. Works with Dentrix, Eaglesoft, Open Dental, Curve, and every other system.
How long does setup take?
60 seconds. We auto-provision your secure subdomain (yourpractice.intake.dental) when you sign up. No IT required, no configuration needed.
Is this really HIPAA compliant?
Yes. We use AES-256 encryption at rest, TLS in transit, and store everything on AWS S3. A Business Associate Agreement (BAA) is automatically included with your subscription.
What happens after 3 months?
After your 3 free months, you'll be charged $199.99/month. There are no contracts - you can cancel anytime. Plus, we offer a 30-day money back guarantee if you're not satisfied.
Can patients fill this out on their phone?
Absolutely. The forms are fully mobile responsive and work perfectly on phones, tablets, and desktops. Most patients prefer filling out forms on their phone before their appointment.
Ready to Save Time and Money?
Join 500+ California practices already using Intake Dental
Claim Your 3 Free Months NowSolo Practice tier only • Enter your promo code • No charge for 3 months • 30-day guarantee