Disability discrimination intake that captures employer size and
The intake walks prospective clients through their condition, the adverse action they faced, employer size, and how recently it happened, then collects termination letters or medical documentation before the file lands in your CRM.
The exact intake your disability discrimination leads complete
This is the real 8-question guided intake for Disability Discrimination — the same flow your customers finish before you ever pick up the phone.
What a qualified disability discrimination lead should tell you
Claims that an employer treated a job applicant or employee worse — through firing, demotion, denied promotion, pay cuts, or discipline — because of an actual, perceived, or past physical or mental health condition, evaluated for coverage, timing, and adverse-action link.
- This Happen At Job
- Have Physical Or Mental
- Believe Disability (Or Perceived
- Generally Able Main Duties
- Employer Have 15 Or
- This Happen Within Last
- Suffer Harm From This,
- Represented By Lawyer This
The questions your team needs answered
Every disability discrimination intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Did this happen at a job in the United States (or with a U.S.-based employer)? | U.S.-based employment establishes ADA and Title I coverage; a claim tied to work performed abroad usually falls outside the firm's jurisdiction. |
| Do you have a physical or mental health condition — or did your employer believe you had one, or know you had one in the past? | Confirms the protected condition — actual, perceived, or past — that any disability discrimination claim must be built around. |
| Do you believe your disability (or perceived disability) was a reason you were treated worse — for example, fired, not hired, demoted, paid less, denied a promotion, or disciplined? | This is the adverse-action link that turns a medical condition into a legally actionable discrimination claim rather than an unrelated workplace dispute. |
| Were you generally able to do the main duties of the job — with or without a reasonable accommodation? | Establishes whether the person was a 'qualified individual' able to perform essential job functions, a threshold requirement under the ADA. |
| Did your employer have 15 or more employees (or are you not sure)? | Employer size determines whether federal ADA coverage applies at all, since the ADA generally requires 15 or more employees. |
| Did this happen within the last 2 years? | Flags whether the claim is likely still within EEOC or state agency charge-filing deadlines before your team invests consultation time. |
| Did you suffer harm from this, such as lost pay/benefits, job loss, missed opportunities, or significant stress or medical impact? | Confirms concrete harm — lost pay, job loss, or documented impact — needed to justify pursuing the matter. |
| Are you currently represented by a lawyer for this disability discrimination matter? | Existing representation on the same matter signals the lead may not need new counsel, which lowers its priority. |
How Cliont scores disability discrimination leads
Every answer is weighted automatically — no manual review required.
Value signals
- This Happen At Job: yes
- Have Physical Or Mental: yes
- Believe Disability (Or Perceived: yes
- Generally Able Main Duties: yes
- Employer Have 15 Or: yes
- This Happen Within Last: yes
Lower-fit signals
- Represented By Lawyer This: no
See the lead your team receives
Disability Discrimination Lead
From first click to qualified lead
Follow people and businesses seeking counsel 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 matter
Smart questions adapt to their matter and capture the full scope.
They share the documents
The facts, dates, and any paperwork come attached, so you can assess the matter before the consultation.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for disability discrimination workflows
| Cliont capability | Disability Discrimination application |
|---|---|
| Weighted scoring | Employer size, adverse-action link, and how recently the incident occurred are weighted together so a fired employee at a 15+ person company scores well above a similar claim against a 5-person employer. |
| Lower-fit flagging | When a prospective client answers that they're currently represented by another lawyer on the same matter, the lead is automatically deprioritized instead of landing in your queue as a fresh case. |
| Guided video intake | Prospective clients can narrate the timeline from disclosing a condition to the adverse action they faced, giving your team context before reviewing the yes/no answers. |
| CRM routing | Qualified disability discrimination matters — those with a clear adverse action, covered employer size, and recent timing — are sent to your CRM pipeline stage for consultation scheduling. |
Common disability discrimination lead scenarios
Fired shortly after diagnosis disclosed
An employee disclosed a new diagnosis and was terminated weeks later at a company with 15+ staff — this combination of adverse action, disability status, and timing pushes the score into High Priority.
Small employer under 15 staff
The employer has fewer than 15 employees, which typically falls outside federal ADA coverage; the intake still captures the claim but flags it as a lower-fit signal for state-law screening instead of an automatic pass.
Already retained counsel
A prospective client is contacting the firm for a second opinion while represented by another lawyer on the same matter; the intake deprioritizes this lead rather than treating it as a new case.
Denied accommodation, still employed
The person remains employed but was denied a requested accommodation with no firing or demotion — the intake surfaces whether this reads closer to Failure to Accommodate than Disability Discrimination based on the adverse-action answer.
Incident outside the two-year window
The alleged discrimination happened over two years ago, which lowers the timing score and prompts an early statute-of-limitations conversation before any consultation is offered.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book matters
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 employment and labor law intake templates
Disability Discrimination lead-intake FAQs
How does the intake handle claims against small employers?
The intake asks whether the employer has 15 or more employees, since that threshold generally determines federal ADA coverage. Leads below that line aren't disqualified outright but are flagged as lower-fit so your team can quickly assess state-law alternatives instead of assuming federal coverage.
What happens if a prospective client already has a lawyer?
The intake asks directly whether the person is currently represented on this disability discrimination matter. A yes answer lowers the lead's priority so your team isn't spending consultation time on a case someone else is already handling.
Does the intake screen for filing deadlines?
Yes — it asks whether the events happened within the last two years, which helps flag claims that may be running up against EEOC or state agency filing windows before your team invests time in a consultation.
What documents does the intake ask leads to upload?
Prospective clients are prompted to upload things like a termination or discipline letter, medical documentation of the condition, performance reviews, and an EEOC charge or right-to-sue letter if one was filed, so your team has supporting material before the first call.
How does this intake differ from the Failure to Accommodate intake?
This intake centers on whether a disability or perceived disability led to an adverse action like firing, demotion, or discipline, while Failure to Accommodate focuses on whether a requested accommodation was denied. The adverse-action question in this catalog is what separates the two.
Can the intake tell whether someone could actually perform the job?
It asks whether the person was generally able to do the main duties of the job, with or without a reasonable accommodation. That answer helps you gauge whether the lead meets the 'qualified individual' standard before you schedule a consultation.
Turn disability discrimination visitors into qualified cases
Give every disability discrimination visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.