Intake Dental - 3 Months Free | California Exclusive Offer
🎁 EXCLUSIVE CALIFORNIA OFFER

Get 3 Months Free

The only dental forms system with 20+ languages, triple-layer encryption, PMS integration, and teledentistry with payments — all live in 60 seconds.

No contracts Works with every PMS Live in 60 seconds 20+ Languages

Solo Practice tier only • Credit card required but not charged for 3 months

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Security Beyond HIPAA
🌐
Languages 20+ Languages
Setup Time 60 Seconds
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Integration PMS Connected

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.

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Save $100-$600/Month

Only $199.99/mo vs $300-$800 competitors charge. No contracts, cancel anytime.

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Triple-Layer Encryption

AES-256-GCM + our proprietary glyph layer — beyond standard HIPAA compliance.

Exclusive Technology

Triple-Protected Patient Data

Your patient data is protected by AES-256-GCM encryption PLUS our proprietary glyph layer — a first in dental software

Patient Enters
Name: Jane Smith
SSN: 123-45-6789
DOB: 01/15/1980
We Store (Encrypted + Glyph)
ᚦᛁᛋᚱᛖᚨᛚᛚᚤᛋᛖᚲᚢᚱᛖeyJlbmNyeXB0ZWQiOnRydWUsImFsZ29yaXRobSI6ImFlcy0yNTYtZ2NtIiwiaXYiOiIzTWlSZy9zOTFtOU1BeU9j...

✅ AES-256-GCM Encryption • ✅ Glyph Layer Obfuscation • ✅ Zero PHI Visible

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Layer 1: AES-256

Military-grade encryption at rest

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Layer 2: GCM Mode

Authenticated encryption in transit

Layer 3: Glyph Layer

Proprietary character obfuscation

Global Accessibility

Speak Your Patient's Language

Dynamic translation of all forms into 20+ languages — patients fill out in their native language

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Patient Selects Language

One click to switch entire form

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Fills Form Natively

Complete form in their language

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Gets Native Email

Confirmation in same language

🇺🇸 English🇪🇸 Español🇨🇳 中文🇻🇳 Tiếng Việt🇰🇷 한국어🇵🇭 Tagalog🇷🇺 Русский🇸🇦 العربية🇫🇷 Français🇩🇪 Deutsch🇧🇷 Português🇯🇵 日本語🇮🇳 हिन्दी🇵🇱 Polski🇹🇷 Türkçe🇮🇹 Italiano🇳🇱 Nederlands🇹🇭 ไทย🇬🇷 Ελληνικά🇮🇱 עברית

✓ RTL Support for Arabic & Hebrew • ✓ Dynamic Translation✓ Native Email Confirmations

Free For All Dental Professionals

Introducing Bridge

The first HIPAA-compliant messaging platform built for dental. Connect with labs in their native language, coordinate with specialists on mutual patients, and chat with colleagues at other offices — completely free, forever.

🔒 Dr. Smith (Endodontist)
Dr. Smith • 10:32 AM
Received the X-ray for patient #4521. I see the periapical lesion on #19.
You • 10:34 AM
Yes, patient experiencing intermittent pain. Can you fit them in this week?
Dr. Smith • 10:35 AM
Thursday 2pm works. I'll send the referral confirmation now. 📋
🌉 Bridge Forum
Dr. Martinez (Miami) • 9:15 AM
Has anyone used the new Straumann BLX in the posterior mandible?
Dr. Kim (Seoul) • 9:18 AM
Yes! Great primary stability. Sharing my case photos now... 📸
You • 9:20 AM
Excellent results! What torque value did you achieve?
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Lab Communication

Message lab techs in their native language with auto-translation

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Specialist Collaboration

Discuss mutual patients securely with endodontists, oral surgeons & more

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Cross-Office Network

Connect with colleagues and friends at other dental offices

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20+ Language Translation

Post in any language, everyone reads in their preferred language

Get Bridge Free →

No credit card required • No strings attached • Free forever

New Revenue Stream

Virtual Consultations with Built-in Payments

Offer paid online consultations and get paid directly to your bank account via Stripe

🦷 Emergency Consultation
$75
⏱️15-minute video call
📋Treatment recommendations
💊Prescription if needed
💳 Pay securely with Stripe
1
Patient pays online
2
Funds to your Stripe
3
Direct deposit to bank

Turn Consultations Into Revenue

Patients pay upfront before booking. Funds go directly to your Stripe Connect account — we never touch your money. Set your own prices for different consultation types.

  • 💰

    Direct Stripe Payments

    Patients pay you directly — funds deposited to your bank account

  • 🎥

    HIPAA-Compliant Video

    Secure video consultations with screen sharing and file upload

  • 📅

    Automated Scheduling

    Patients book available slots — syncs with your calendar

  • 🏷️

    Custom Pricing

    Set different prices for emergency, cosmetic, second opinion & more

AI-Powered

Ask Your Practice Anything

AI connects to your PMS and answers questions in plain English — no training required

AI That Knows Your Practice

Our Complete Front Office Automation add-on connects directly to your PMS with AI that understands plain English. Ask anything — patient lookups, contact info, reports, analytics. Just type like you're texting a colleague.

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    Instant Patient Lookup

    "What's John Smith's phone number?" — answered in seconds

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    Any Question, Any Data

    "How many patients named John?" "Who's due for a cleaning?"

  • 📊

    Reports on Demand

    Aging reports, production stats, marketing ROI — just ask

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    Insurance Verification

    Real-time eligibility checks before patients arrive

💬
Ask Anything

"John Smith's phone number please"

🤖
AI Queries Your PMS

Dentrix, Eaglesoft, Open Dental & more

Instant Answer

"(555) 123-4567 - Last visit: Dec 15"

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Or Full Reports

"Show aging over 90 days" → instant report

🚀 New Feature — Save Hours Every Week

Auto EOB Payment Posting

Stop manually entering insurance payments. Upload your EOBs and checks — AI extracts the data, matches to claims, and posts to your PMS automatically.

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Auto EOB Payment Posting

AI-powered • Bulk upload supported

1
Upload Check + EOB

Snap a photo or upload scanned images. Supports multi-page EOBs and bulk ZIP uploads.

2
AI Extracts Payment Data

Check number, amounts, patient names, procedure codes, deductibles — all extracted automatically.

3
Match to Patient Claims

Fuzzy name matching finds the right patients even when insurance formats names differently.

4
Review & Post to PMS

One-click posting to patient ledgers. Duplicate check protection built-in.

100+
EOBs per batch
95%
Auto-match rate
2 min
Per batch

End Manual Payment Entry Forever

Front office staff spend 2-4 hours daily manually posting insurance payments. Our AI reads your EOBs, matches to the right patients, and posts payments — turning hours into minutes.

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    Bulk Upload Support

    Upload individual EOBs or ZIP files with up to 100 EOBs at once.

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    Smart Name Matching

    AI handles "SMITH, JOHN A" → "John Smith" variations automatically.

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    Duplicate Protection

    Warns if a check number was already posted. Never double-post.

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    Multi-Page EOBs

    Combine multiple pages into a single EOB. All line items extracted.

Save 10+ Hours Every Week

See the difference Auto EOB Posting makes for your practice

Manual Entry
3-4
hours per day
With Auto EOB
15
minutes per day

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
  • Replace your phone system
  • Pay $300-$800/month
  • Wait weeks for setup
  • English-only forms
  • No virtual revenue stream
  • Days of staff training
  • Use unsecure texting for PHI
  • Manual EOB entry for hours

✓ The Intake Dental Way

  • Month-to-month, cancel anytime
  • Keep all current systems
  • From just $199.99/month
  • Live in 60 seconds
  • 20+ languages built-in
  • Paid teledentistry with Stripe
  • 10-minute learning curve
  • Free Bridge messaging for everyone
  • Auto EOB posting in minutes

All Forms Included

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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
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Appointment Forms

  • New patient booking
  • Existing patient updates
  • Health history updates
  • Auto-populate data
  • Mobile responsive
🎁 CALIFORNIA EXCLUSIVE: 3 MONTHS FREE

Claim Your 3 Free Months

$0/mo

For your first 3 months

Credit card required but not charged
Then $199.99/mo after 3 months
Save $599.97 total
No contracts - cancel anytime
30-day money back guarantee

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."

Dr. Sarah M., Sacramento

★★★★★

"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."

Dr. James T., Los Angeles

★★★★★

"HIPAA compliance was a nightmare until we found this. The BAA is included and everything is encrypted. Finally peace of mind."

Dr. Maria R., San Diego

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-GCM encryption plus our proprietary glyph layer at rest, TLS in transit, and store everything on AWS S3. A Business Associate Agreement (BAA) is automatically included with your subscription.

What is Bridge and is it really free?

Bridge is 100% free forever for all dental professionals. It's HIPAA-compliant messaging to connect with labs, specialists, and colleagues. We built it because dental professionals deserve secure communication without the price tag.

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 in other languages?

Absolutely. The forms are fully mobile responsive and work perfectly in 20+ languages including Spanish, Chinese, Vietnamese, Korean, Arabic (with RTL support), and many more. Patients receive confirmations in their selected language too.

Ready to Save Time and Money?

Join 500+ California practices already using Intake Dental

Solo Practice tier only • Enter your promo code • No charge for 3 months • 30-day guarantee