Orthodontic New Patient Form
What an orthodontic new patient form asks, why each part matters, and how orthodontic practices collect it.
An orthodontic new patient form records a patient's dental and orthodontic history, main concerns, medical history, and insurance before the first visit to an orthodontist. It's also called an orthodontic consultation questionnaire.
Orthodontic new patient form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on an orthodontic new patient form in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample orthodontic new patient form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Who is your general dentist?Patient details
- Who may we thank for referring you?Patient details
- When was your last dental cleaning?Dental history
- Is any dental work pending or planned?Dental history
- Have you had orthodontic treatment before?Orthodontic history
- Has anyone in your family worn braces?Orthodontic history
- What is your main orthodontic concern?Concerns
- Do your jaws click, pop, or lock?Concerns
- Do you need antibiotics before dental treatment?Medical history
- Are you allergic to any medicines or latex?Medical history
- Does your insurance cover orthodontic treatment?Insurance
- Would you prefer a monthly payment plan?Insurance
These are examples to read, not a form to fill in.
Orthodontic new patient form: FAQ
What does an orthodontic new patient form ask?
It covers six areas: patient details, dental history, orthodontic history, concerns and treatment goals, medical history, and insurance and payment.
Who fills in an orthodontic new patient form, and when?
The patient, or a parent for a child, before the first consultation.
Why does an orthodontist need the patient's medical history?
The form asks about conditions, medicines, drug or latex allergies, and any need for antibiotics before dental treatment. The orthodontist reads the answers before the exam.
Is it the same as an orthodontic patient registration form?
They overlap. A registration form is the administrative part: contact details, responsible party, and insurance. The new patient form adds the dental, orthodontic, and medical history.
Is there a standard orthodontic new patient form?
The sample questions on this page show a typical set. Practice forms differ in how they ask about treatment goals and payment.
What happens after the form is complete?
The orthodontist reviews the answers, examines the patient, may take records such as photos or X-rays, and discusses treatment options. The form does not decide the treatment.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
