Bright Smiles Orthodontics · patient profile

Patient profile

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LK

Lily K. · “Lily

Age 8 · Phase 1 · Consult booked · Centerville office

Gender
F
Date of birth
2018-02-19
Lead source
Facebook ad
First contact
2026-05-24
Existing family here
No

Treatment intent

Main concern
Mom noticed some crowding coming in and wants to know if it's time for a first look.
Category
Phase 1 eval
Seen an ortho before
No
Transfer patient
No
Same-day-start response
Reassured that 7 to 8 is a great age for a first visit; booked happily.

Household & decision makers

Primary contact
Mom
Who brings patient
Mom
Mom
Emily K. · (937) 555-0461
Dad
Mark K. · (937) 555-0462
Email
emily.k@email.com
City
Centerville
ZIP
45458
Mailing address
88 Sycamore Glen, Centerville, OH 45458
Parents same address
Yes
Both parents attending
No

Clinical context

Locked — Lane 2 (PHI)

Requires elevated role.

Clinical context

Lane 2 · staff only · never sent to AI
Referring dentist
Dr. Patel, Centerville Family Dental
Dental work completed
Yes
Last cleaning
2026-03-30
Clinical flags
None on file

Insurance

Locked — Lane 2 (PHI)

Requires elevated role.

Insurance

Lane 2 · staff only · never sent to AI
Wants verification
Yes
Verification status
Verified
Has secondary
No

Primary

Insured
Emily K.
Insured DOB
1989-05-12
SSN
•••-••-4461 · encrypted at rest, held in the PMS
Employer
Premier Health
Carrier
Delta Dental
Carrier phone
(800) 555-0100
Member ID
DD-44610082
Group #
GRP-1180

Visit

Appointment
2026-05-26 · 3:00 PM
Type
In person consult
Knows the office
Yes
Paperwork sent
Yes
Paperwork returned
No
Same-day-start expectation set
No
Est. consult duration
30 min early-eval

Activity & notes

Call taken by (AC)
KM
Created
2026-05-24
Updated
2026-05-27

Call notes

Anxious-but-excited mom of an 8-year-old. Wants a no-pressure first look. Likely a watch-or-Phase-1 decision at the visit.

Follow-ups

  • Send new-patient paperwork link· 2026-05-25
  • Confirm Tuesday 3:00 the day before· 2026-05-25
parentearly-evalconsult-booked