Denture Screening Click for Form Instruction CLICK HERE for Form Instructions Black Text & Pointing Finger Indicates Form Instruction Suggested Script for Patient Click on Your Name -patient lead 2.0 Cindy Kelsey Nate Pam Red Ryan Sally Tom Scripts show scripts Show Me the Voicemail Scripts Show Me the Connection Scripts Facebook Voicemail Script Hi [Patient’s First Name], this is [Your Name] from Dentacor. I saw that you recently inquired about our In-Home Denture service through Facebook, and I’d love to learn more about your needs to see how we can help. Feel free to call me back at this number or send a quick text with a good time to chat. Looking forward to connecting with you—have a great day! Referral Voicemail Script Hi Patient First Name, this is Your Name from Dentacor. → {Referrer's Name} referred you to us as someone who may be interested in our "Dentacor In-Home Denture" service → We are calling to get a bit more information about your situation to see if we are a good fit → You can call us back on this number or text us as well with a good time to talk Have a great day! Generic Voicemail Script Hi Patient's First Name, this is Your Name from Dentacor. →We are calling to talk to you about our "In-Home Denture" service →You can call us back on this number or text us as well with a good time to talk Have a great day! Facebook Phone Script Hi Patient's First Name, this is Your Name from Dentacor. → You Recently responded to a Facebook Ad about our "In-Home Denture" service → We are calling to get a bit more information about your situation and to see if we are a good fit Do you have a minute to talk? Referral Phone Script Hi Patient's First Name, this is Your Name from Dentacor. → We are calling to talk to you about our "In-Home Denture" service →I calling to learn a bit more about your situation and to see if we are a good fit Do you have a minute to talk? Generic Phone Script Hi Patient's First Name, this is Your Name from Dentacor. → {Referrer's Name} referred you to us as someone who may be interested in our "Dentacor In-Home Denture" service → We are calling to get a bit more information about your situation to see if we are a good fit Do you have a minute to talk? Patient Information Fill in All Available Patient Info Full Name Preferred Name DI# -Apartment Building or Shelter Name 3 Links Tower7th Street TreatmentAll AbilitiesAll AbilitiesAperture Testing LabAthertonBaylors HouseBeecon RecoveryBonnevilleBristol VillageBristol Village Building "A"Brooke MunsonBud BaileyCannon Heights Adult Learning CenterCapital VillaCatholic Community Center St. Vincent Dining HallCBC CLINICCentral City ApartmentsCentral Utah Veterans Home - PaysonCHRISTMAS BOX HOUSECOUNTY HIGH RISEDADiamond RecoveryDominguez ParkEagle View TownhomesEscalanteFairpark ApartmentsFellowship ManorFirst Step House GrantFortitude CorrectionalFortitude CorrectionalFreedom LandingFriendship ManorGail Miller Resource CenterGAIL MILLER RESOURCE CENTERGERALDINE E. KINGGlendale Senior HousingHamiltonHamilton PlaceHarmony GardensHaven Men's DowntownHolding Out HelpHolding Out Help/Holly's HomeHomeless Resource FairsHouse Of HopeHousing AuthorityHousing ConnectHurricane Hills Town HomesIncline at AnthemINDIVIDUAL SCHEDULEIOOF TowerJerald MerrillJourney Treatment CenterJOURNEY TREATMENT CENTER/BAYLORKelly BensonKelly Benson ApartmentsKOERNER INSTITUTELegacy House TaylorsvilleLIBERTY RECOVERY RESIDENTIALLiberty Recovery- WEST JORDANLIBERTY WELLS SENIOR CENTERLincoln TowersLowell ApartmentsMartha's TerraceMicro ShelterMulti-Ethnic Sr CitzenMVPMVPNorthern Utah Community Correctional CenterNUCCOdyssey House Fact TeamODYSSEY HOUSE FACT TEAMOdyssey House IntakeOdyssey House LighthouseOdyssey House Men's In HouseOrange Street CorrectionsPalmer CourtPamela Atkinson Resource CenterParkway CommonsPhillips Plaza Senior ApartmentsPhoenix RecoveryPlymouthPlymouth ViewPrestonPreston PlaceRed Cliff Manor ApartmentsRendon TerraceRescue MissionRescue Mission of Salt LakeRevolve ApartmentsRichmond FlatsRoadhome- MidvaleRoads to IndependenceSalt Lake City LibrarySean Herrick ApartmentsSenior Living On WashingtonSharon GardensSharon GardensSilver Pines ApartmentsSt Benedict ManorSt Marks TowerSt. Marks GardenSURGICAL CENTERSwitchpoint Overflow ShelterSwitchpoint Overflow ShelterTaylor GardensTaylor SpringsTesting clientThe ArenaThe GardenThe Garden at South JordanTHE HAVENThe Haven - South JordanThe Haven- Men's DowntownThe Haven-West Jordan Men'sThe Ivy-DraperThe Point SLCTHE ROAD HOMEThe Ville Rose ParkTHE VILLE- MAGNATHE VILLE- OVERFLOW SHELTERThrive RecoveryTIMPANOGAS COMMUNITY CORRECTIONAL CENTERTIMPANOGAS COMMUNITY CORRECTIONAL CENTERUnion GardensUtah Harm ReductionValley Fair VillageVictoria Woods SandyVictoria Woods West ValleyVictory OutreachVillage SquareVOA DETOXWARM SPRINGS PARKWasatch ManorWatercourse WayWest Jordan Correctional FacilityWEST JORDAN CORRECTIONAL FACILITYWest Jordan IIWest Jordan IIWest Jordan Senior HousingWillowood ApartmentsYRCYWCA Phone Email Street Address City Zip info is ready CLICK HERE- WHEN ALL INFO HAS BEEN ADDED INFO BELOW IS FOR REFERENCE ONLY - DO NOT EDIT Last Reachout Out Attempt Date How Many Attempts to Contacts Insurance Type Indicated Referrer Did they answer Did Patient Answer Phone? Yes, they answered No, they DID NOT answer RO Record Let Us Know What Happens Next? -RO Record * Left Message & Send Text Phone Disconnected Left Message Wrong Phone # Send Text Hung Up on Me No Message, No Text Asked Us Not To Reachout Again text will be sent A Text will be Sent to Patient when Form is Submitted (if you would like to manually send a text, check the indicated checkbox below) Do Not Send Scripted- I will Manually Send Text Do Not Send Scripted- I will Manually Send Text Click "Next Steps & Submit" How did you hear about us How Did You Hear About Us? -How did you hear about us? Dentacor Team Member Facebook Ad Dentacor Patient Sr Apartment General Referrer Flyer Other Undisclosed INDICATE "OTHER" HERE Dentacor Patient What Dentacor Patient do we have to thank for referring you to us? Dentacor Patient Referrer's Name: Referring Patients DI# * If Unavailable- add "0" CLICK BELOW WHEN ALL REFERRING PATIENT'S INFO IS INDICATED CLICK BELOW WHEN ALL REFERRING PATIENT'S INFO IS INDICATED Dentacor Team Member What Dentacor Team Member Referred You? Who referred you to us? CLICK HERECindy MarinDax RappNate WilsonPam SitterudRyan NilssonRedTom WilsonOther Who referred you to us? Apartment or Shelter In what building did you hear about us? -CLICK HERE TO INDICATE PATIENT APARTMENT OR BUILDING 3 Links Tower7th Street TreatmentAll AbilitiesAll AbilitiesAperture Testing LabAthertonBaylors HouseBeecon RecoveryBonnevilleBristol VillageBristol Village Building "A"Brooke MunsonBud BaileyCannon Heights Adult Learning CenterCapital VillaCatholic Community Center St. Vincent Dining HallCBC CLINICCentral City ApartmentsCentral Utah Veterans Home - PaysonCHRISTMAS BOX HOUSECOUNTY HIGH RISEDADiamond RecoveryDominguez ParkEagle View TownhomesEscalanteFairpark ApartmentsFellowship ManorFirst Step House GrantFortitude CorrectionalFortitude CorrectionalFreedom LandingFriendship ManorGail Miller Resource CenterGAIL MILLER RESOURCE CENTERGERALDINE E. KINGGlendale Senior HousingHamiltonHamilton PlaceHarmony GardensHaven Men's DowntownHolding Out HelpHolding Out Help/Holly's HomeHomeless Resource FairsHouse Of HopeHousing AuthorityHousing ConnectHurricane Hills Town HomesIncline at AnthemINDIVIDUAL SCHEDULEIOOF TowerJerald MerrillJourney Treatment CenterJOURNEY TREATMENT CENTER/BAYLORKelly BensonKelly Benson ApartmentsKOERNER INSTITUTELegacy House TaylorsvilleLIBERTY RECOVERY RESIDENTIALLiberty Recovery- WEST JORDANLIBERTY WELLS SENIOR CENTERLincoln TowersLowell ApartmentsMartha's TerraceMicro ShelterMulti-Ethnic Sr CitzenMVPMVPNorthern Utah Community Correctional CenterNUCCOdyssey House Fact TeamODYSSEY HOUSE FACT TEAMOdyssey House IntakeOdyssey House LighthouseOdyssey House Men's In HouseOrange Street CorrectionsPalmer CourtPamela Atkinson Resource CenterParkway CommonsPhillips Plaza Senior ApartmentsPhoenix RecoveryPlymouthPlymouth ViewPrestonPreston PlaceRed Cliff Manor ApartmentsRendon TerraceRescue MissionRescue Mission of Salt LakeRevolve ApartmentsRichmond FlatsRoadhome- MidvaleRoads to IndependenceSalt Lake City LibrarySean Herrick ApartmentsSenior Living On WashingtonSharon GardensSharon GardensSilver Pines ApartmentsSt Benedict ManorSt Marks TowerSt. Marks GardenSURGICAL CENTERSwitchpoint Overflow ShelterSwitchpoint Overflow ShelterTaylor GardensTaylor SpringsTesting clientThe ArenaThe GardenThe Garden at South JordanTHE HAVENThe Haven - South JordanThe Haven- Men's DowntownThe Haven-West Jordan Men'sThe Ivy-DraperThe Point SLCTHE ROAD HOMEThe Ville Rose ParkTHE VILLE- MAGNATHE VILLE- OVERFLOW SHELTERThrive RecoveryTIMPANOGAS COMMUNITY CORRECTIONAL CENTERTIMPANOGAS COMMUNITY CORRECTIONAL CENTERUnion GardensUtah Harm ReductionValley Fair VillageVictoria Woods SandyVictoria Woods West ValleyVictory OutreachVillage SquareVOA DETOXWARM SPRINGS PARKWasatch ManorWatercourse WayWest Jordan Correctional FacilityWEST JORDAN CORRECTIONAL FACILITYWest Jordan IIWest Jordan IIWest Jordan Senior HousingWillowood ApartmentsYRCYWCA General Referral Who do we have to thank for referring you to us? Referrer's Name Referrers Phone # No Phone- Add "0" to Field CLICK HERE WHEN ALL AVAILABLE REFERRER INFO HAS BEEN ADDED * CLICK HERE WHEN ALL AVAILABLE REFERRER INFO HAS BEEN ADDED patient info complete PATIENT INFO PAGE IS COMPLETE Patient InfoDental InfoInsurance InfoPayment Results Page 5 Δ