Bright Smiles Orthodontics · patient profile

Patient profile

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Maya M. · “Maya

Age 11 · Tween · No book · Centerville office

Gender
F
Date of birth
2015-03-14
Lead source
Google search
First contact
2026-05-20
Existing family here
No

Treatment intent

Main concern
Crowding on her top teeth, wants options and cost.
Category
Crowding
Seen an ortho before
No
Transfer patient
No
Same-day-start response
Open to it, but wants to compare cost against a chain quote first.

Household & decision makers

Primary contact
Mom
Who brings patient
Mom
Mom
Sarah M. · (937) 555-0148
Dad
Greg M. · (937) 555-0149
Email
sarah.m@email.com
City
Centerville
ZIP
45459
Mailing address
412 Maple Ave, Centerville, OH 45459
Parents same address
Yes
Both parents attending
No
Attendance notes
Dad works days; mom attended the consult solo.

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
2026-04-02
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
Sarah M.
Insured DOB
1988-07-22
SSN
•••-••-1234 · encrypted at rest, held in the PMS
Employer
Kettering Health
Carrier
Delta Dental
Carrier phone
(800) 555-0100
Member ID
DD-88241007
Group #
GRP-4471

Visit

Appointment
2026-05-22 · 5:00 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
2026-05-20
Updated
2026-05-26

Call notes

Mom focused on cost vs. a corporate-chain quote. Maya is a strong candidate. No clinical concerns. Follow up with a financing breakdown.

Follow-ups

  • Send itemized financing options· 2026-05-27
  • Run cost-objection recovery sequence· 2026-05-27
parentcost-objectionconsult-heldno-book