๐Ÿฆท Dental Forms Pro - Live Demo

Experience the complete patient intake system with encryption, auto-signatures, and instant PDFs

Complete Patient Intake Form

1
Personal Info
2
Medical History
3
Insurance
4
Signatures

Personal Information

/ /
SECURE PDF

Your Dental Practice

Patient Intake Form

Patient: John Doe

Date: January 15, 2024

Status: โœ“ Encrypted & Signed

โœ“ Form Submitted Successfully

PDF generated and sent via secure email

This PDF contains all 4 pages of patient information including personal details, medical history, insurance information, and digital signatures.

Complete Form Library

12 comprehensive forms covering all patient interactions

๐Ÿ“‹ Standard Forms

  • Health History Update
  • New Patient Appointment
  • Existing Patient Appointment
  • Contact Form
  • Patient Referral
  • Patient Feedback

๐Ÿ“ Consent Forms

  • General Consent
  • Extraction Consent
  • Crown and Bridge Consent
  • Bone Graft Consent
  • Implant Consent
  • Scaling & Root Planing Consent

All forms feature:

Digital signatures โ€ข Instant PDF generation โ€ข Email notifications โ€ข Secure encryption

Military-Grade Encryption

Watch how patient data is encrypted before storage

Original Data:
{
  "name": "John Doe",
  "ssn": "123-45-6789",
  "dob": "1985-03-15",
  "insurance": "Delta Dental"
}
๐Ÿ”
AES-256
Bank-level encryption
๐Ÿ›ก๏ธ
HIPAA Compliant
Meets all requirements
๐Ÿ”‘
Secure Keys
Unique per practice

Smart Health History Updates for Existing Patients

Patients update only what has changed since their last visit

Step 1: Quick Verification

/ /

Benefits of Smart Health Updates

โฑ๏ธ
Save Time

Update in 30 seconds instead of 10 minutes

โœ…
Accuracy

No re-entering unchanged data

๐Ÿ“Š
Better Records

Track changes over time

๐Ÿ˜Š
Patient Satisfaction

No repetitive paperwork

Automated Doctor Signatures

Doctors can configure auto-signing for different form types

Doctor Signature Settings

Signed Document

I have reviewed this patient's information and approve the treatment plan.

Dr. Sarah Smith, DDS

License: DDS-12345

2024-01-15

Date

HIPAA-Compliant Email Notifications

Secure notifications with AWS S3 PDF links

Digital Consent Forms

6 specialized consent forms with digital signatures

๐Ÿ“
General Consent
Financial arrangements and treatment authorization
๐Ÿฆท
Extraction Consent
Oral surgery and extraction procedures
๐Ÿ‘‘
Crown/Bridge
Restorative procedure consent
๐Ÿฆด
Bone Graft
Bone augmentation procedures
๐Ÿ”ฉ
Implant Consent
Dental implant placement
๐Ÿงน
Scaling & Root Planing
Deep cleaning procedure consent

Complete Feature Set

Everything your dental practice needs

๐Ÿ”
AES-256 Encryption
Military-grade encryption for all patient data
๐Ÿ“‹
12 Form Types
6 forms + 6 consent forms for complete coverage
๐Ÿ“ง
Smart Emails
HIPAA-compliant notifications with secure links
โ˜๏ธ
AWS S3 Storage
Secure cloud storage with 7-day expiring links
โœ๏ธ
Auto-Signatures
Configure doctor signatures once
๐Ÿฅ
HIPAA Compliant
Full compliance with all regulations
๐Ÿ”„
Health Updates
Patients update their own records
๐Ÿ“ฑ
Mobile Ready
Works perfectly on all devices
โšก
Instant PDFs
Generate PDFs immediately on submission
Patient Intake
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