Dentist and clinics

Teeth whitening enquiry

Smokers and coffee drinkers get extra advice, and past sensitivity asks which kind. Free to use with FillKite.

What is in this form

Your name (required)
Email (required)
Which treatment interests you? (required)
Do you…
Do you have sensitive teeth? (required)
How sensitive?
Any crowns or veneers?

How the conditional logic works

This form shows or hides fields as people answer, so everyone sees only what matters to them.

A notice appears only when “Do you…” includes “Smoke”.
“How sensitive?” appears only when “Do you have sensitive teeth?” is “Yes”.

Use it on your site

Install FillKite free from WordPress.org.
Download this form with the button above.
Go to FillKite → Import → From a FillKite file, choose the file and import it.

Questions

About this form

Is the teeth whitening enquiry form free?

Yes. It works with the free FillKite plugin, and you can download it and change it as you like.

Is anything I type saved?

No. This demo runs in test mode: FillKite checks your answers like a real form, but nothing is saved and no email is sent.

How do I use this form on my site?

Install FillKite, download the form with the button on this page, then go to FillKite → Import → From a FillKite file and choose the file. After importing, open it in the builder, change anything you like and add it to a page.

Does this form use conditional logic?

Yes. 2 fields or notices show only when earlier answers call for it. A notice appears only when “Do you…” includes “Smoke”.

What fields does it have?

It has 7 fields: Your name, Email, Which treatment interests you?, Do you…, Do you have sensitive teeth?, How sensitive?, Any crowns or veneers?.

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Free on WordPress.org

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