Bright Smiles Orthodontics · patient profile

Patient profile

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Brooke R. · “Brooke

Age 12 · Tween · Converted · Centerville office

Gender
F
Date of birth
2014-04-03
Lead source
Google search
First contact
2026-05-05
Existing family here
Yes

Treatment intent

Main concern
Crowding and a deep bite; mom was ready to start and wanted the financing options.
Category
Crowding
Seen an ortho before
No
Transfer patient
No
Same-day-start response
Ready to go at the consult; started treatment the same week.

Household & decision makers

Primary contact
Mom
Who brings patient
Mom
Mom
Olivia R. · (937) 555-0610
Dad
Greg R. · (937) 555-0611
Email
olivia.r@email.com
City
Centerville
ZIP
45459
Mailing address
615 Whipp Rd, Centerville, OH 45459
Parents same address
Yes
Both parents attending
Yes

Clinical context

Locked — Lane 2 (PHI)

Requires elevated role.

Clinical context

Lane 2 · staff only · never sent to AI
Referring dentist
Dr. Okafor, Far Hills Dental
Dental work completed
Yes
Last cleaning
2026-04-20
Clinical flags
deep bite, monitoring

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
Olivia R.
Insured DOB
1986-09-17
SSN
•••-••-6610 · encrypted at rest, held in the PMS
Employer
Montgomery County Schools
Carrier
Anthem Blue Cross Blue Shield
Carrier phone
(800) 555-0155
Member ID
BCBS-66100143
Group #
GRP-2090

Visit

Appointment
2026-05-08 · 3:00 PM
Type
In person consult
Knows the office
Yes
Paperwork sent
Yes
Paperwork returned
Yes
Same-day-start expectation set
Yes
Est. consult duration
60–90 min

Activity & notes

Call taken by (AC)
KM
Created
2026-05-05
Updated
2026-05-15

Call notes

Existing family at the practice (older sibling treated here). Mom decisive, started braces May 15. Now in active treatment; routine adjustments on the calendar.

Follow-ups

  • Schedule first adjustment (6 weeks)· 2026-06-26
  • Send braces-care welcome kit· 2026-05-16
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