Dermal filler intake that captures treatment timing up front
Every dermal filler enquiry captures the treatment area, prior filler history, pregnancy or breastfeeding status, and desired timeline before it lands in your CRM, along with a photo of the area the client wants treated.
The exact intake your dermal filler consultation leads complete
This is the real 6-question guided intake for Dermal Filler Consultation — the same flow your customers finish before you ever pick up the phone.
What a qualified dermal filler consultation lead should tell you
An initial appointment where a licensed injector reviews a client's desired treatment area, filler history, and contraindications before recommending a hyaluronic acid or other filler treatment plan.
- Area Most Interested In
- Had Dermal Filler Treatments
- Free From Pregnancy Or
- Treatment Area Free Active
- Schedule Treatment
- Have Any Known Allergies
The questions your team needs answered
Every dermal filler consultation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Which area are you most interested in treating with filler? | The selected treatment area tells the injector which technique and product to prepare for before the consult even starts. |
| Have you had dermal filler treatments before? | Prior filler experience helps the injector gauge how much education the consult needs versus how quickly the client can move to treatment. |
| Are you free from pregnancy or breastfeeding at this time? | Pregnancy or breastfeeding is a contraindication for filler, so a 'no' answer should hold the appointment rather than let it book as chair-ready. |
| Is the treatment area free of active skin infections or breakouts? | An active infection or breakout in the treatment area usually means the appointment needs to be rescheduled, so this answer is treated as urgent. |
| When are you hoping to schedule your treatment? | Desired scheduling timeline is the strongest signal for how soon a lead is ready to book, and it directly drives lead priority. |
| Do you have any known allergies to filler ingredients such as hyaluronic acid? | Known allergies to filler ingredients like hyaluronic acid let the injector prepare an alternative product before the client arrives. |
How Cliont scores dermal filler consultation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Free From Pregnancy Or: yes
- Treatment Area Free Active: yes
- As soon as possible
- Within a month
- Within 3 months
- Just exploring options
Urgency signals
- Treatment Area Free Active
See the lead your team receives
Dermal Filler Consultation Lead
From first click to qualified lead
Follow clients and members through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the appointment
Smart questions adapt to their appointment and capture the full scope.
They add reference photos
Inspiration and reference photos come attached, so you prep the right look.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for dermal filler consultation workflows
| Cliont capability | Dermal Filler Consultation application |
|---|---|
| Conditional scoring logic | Weighs pregnancy/breastfeeding status and active skin condition answers together, so leads with contraindications are flagged for review instead of automatically booked. |
| Photo upload capture | Collects a photo of the treatment area a client selects — lips, cheeks, under eyes, jawline, or nasolabial folds — so the injector can assess the area before the consult. |
| Timeline-based prioritization | Surfaces leads who chose 'as soon as possible' or 'within a month' above those who selected 'just exploring options,' so urgent bookings don't get buried. |
| Structured lead routing to CRM | Sends treatment area, filler history, and eligibility answers straight into the CRM record so front-desk staff aren't re-asking questions the client already answered. |
Common dermal filler consultation lead scenarios
First-time filler, wants it fast
A new client selects lips or cheeks, has never had filler, and picks 'as soon as possible' — the intake flags this as high-value and time-sensitive so it surfaces ahead of slower enquiries.
Repeat client just exploring
A returning filler client marks 'just exploring options' with no urgency — the intake still confirms eligibility but the timeline signal keeps it out of the priority queue for chairs held short-term.
Active breakout at treatment site
A lead answers that the treatment area is not free of active skin infection or breakouts, triggering the urgency signal so staff can reschedule rather than confirm an appointment that can't proceed as planned.
Pregnancy or breastfeeding disclosed
A client indicates they are not free from pregnancy or breastfeeding, which lowers the eligibility score and prompts a hold on booking until that status changes.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book appointments
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More medical spa intake templates
Dermal Filler Consultation lead-intake FAQs
How does the intake handle a client who discloses an allergy to hyaluronic acid?
The allergy question is captured directly on the form so your team sees it before the appointment is confirmed, letting the injector review ingredient options or steer the client toward an alternative filler.
What happens if a lead says they're pregnant or breastfeeding?
That answer carries a low weight in scoring, which keeps the lead from being treated as chair-ready until the client confirms they're clear to proceed, rather than reserving a slot for a treatment that can't happen yet.
Can the intake tell me which area a client wants treated before I call them?
Yes — leads select lips, cheeks, under eyes, jawline or chin, nasolabial folds, another area, or 'not sure,' so your CRM shows the target area alongside the rest of the consult details.
Does the treatment timeline actually change how leads get prioritized?
Yes. 'As soon as possible' and 'within a month' carry more weight than 'just exploring options,' so urgent bookings rise above enquiries that aren't ready to commit yet.
What if a client reports an active breakout in the area they want filled?
That answer is flagged as an urgent signal in the scoring, since it typically means the injector needs to reschedule rather than hold a chair for a treatment that can't go ahead as booked.
Is prior filler experience used to qualify the lead?
Yes, the intake asks whether the client has had filler before, giving your injector context on the consult before it's even in the CRM.
Turn dermal filler consultation visitors into qualified appointments
Give every dermal filler consultation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you hold a chair.