FMLA leave intake that checks the 1,250-hour rule up front
The intake checks 12-month tenure, the 1,250-hour threshold, and employer size before asking for leave denial or termination records, so you see FMLA eligibility before you offer a consultation.
The exact intake your fmla leave leads complete
This is the real 8-question guided intake for FMLA Leave — the same flow your customers finish before you ever pick up the phone.
What a qualified fmla leave lead should tell you
A claim involving an employee's right to unpaid, job-protected leave under the federal Family and Medical Leave Act for a serious health condition, family caregiving, pregnancy/birth, or military-related reasons.
- Issue About Taking Leave
- Work This Employer At
- In 12 Months Before
- Employer Have 50 Or
- Tell Employer Needed Leave
- Employer Deny Leave, Discourage
- After Requested Or Took
- This Happen Within Last
The questions your team needs answered
Every fmla leave intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Is your issue about taking leave from a job in the U.S. for your own serious health condition, to care for a close family member, for pregnancy/birth, or for a qualifying military-related reason? | Confirms the issue is actually a leave reason FMLA covers, not a different kind of workplace dispute. |
| Did you work for this employer for at least 12 months before the leave issue happened? | Rules out employees who haven't met the 12-month tenure threshold required for FMLA coverage. |
| In the 12 months before the leave issue, did you work at least about 1,250 hours for this employer? | Checks the 1,250-hour threshold, a hard eligibility cutoff separate from tenure length. |
| Does your employer have 50 or more employees within about 75 miles of your worksite? | Employer size within 75 miles is a coverage requirement independent of the employee's own eligibility. |
| Did you tell your employer you needed leave (or that you were out for a medical/family reason) and provide the information they reasonably asked for? | A "yes" flags a higher-value, higher-urgency lead you’ll want to reach first. |
| Did your employer deny your leave, discourage you from taking it, delay it unreasonably, or count it against you as an attendance problem? | Distinguishes an actual denial, discouragement, or interference claim from a simple leave question. |
| After you requested or took leave, were you fired, demoted, had your pay/hours cut, or otherwise punished? | Post-leave punishment is weighted highest because it points toward a stronger, more litigable claim. |
| Did this happen within the last 2 years? | Flags claims outside the typical FMLA limitations period before a consultation is booked. |
How Cliont scores fmla leave leads
Every answer is weighted automatically — no manual review required.
Value signals
- Issue About Taking Leave: yes
- Work This Employer At: yes
- In 12 Months Before: yes
- Employer Have 50 Or: yes
- Tell Employer Needed Leave: yes
- Employer Deny Leave, Discourage: yes
See the lead your team receives
FMLA Retaliation 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 fmla leave workflows
| Cliont capability | FMLA Leave application |
|---|---|
| Weighted scoring | Tenure, hours worked, and employer size combine into a single coverage score before retaliation or denial answers are even weighed. |
| Guided intake logic | Post-leave termination or pay cuts are weighted highest, so a caller fired after leave surfaces above a caller with a simple denial. |
| Video widget | Lets the caller narrate the leave request, the employer's response, and what happened afterward in their own words. |
| CRM routing | Matters that clear the tenure, hours, and employer-size thresholds route to your CRM with leave and termination documents attached. |
Common fmla leave lead scenarios
Leave denied outright
Employer denied, discouraged, or delayed the leave request but the caller is still employed, so the intake flags a strong interference claim without yet showing retaliation.
Fired after taking leave
The caller took leave and was then terminated, demoted, or had pay cut, which combined with confirmed eligibility produces the highest-scoring lead.
Small employer, no coverage
Fewer than 50 employees within 75 miles means the employer isn't covered by FMLA, so the intake surfaces this as a lower-fit matter even if leave was denied.
New hire, not yet eligible
The caller hasn't reached 12 months or 1,250 hours with the employer, so the intake flags a tenure or hours gap before a consultation is booked.
Claim outside two-year window
The leave issue happened more than two years ago, so the intake flags a possible timing problem for the attorney to weigh before scheduling.
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
FMLA Leave lead-intake FAQs
How does the intake test FMLA eligibility before a consultation?
It walks the caller through employer tenure, hours worked, and employer size, the three coverage thresholds that determine whether FMLA even applies before you spend time on the matter.
Does the intake separate a plain leave denial from retaliation?
Yes, denial or interference and post-leave punishment are asked as separate questions, so you can see whether the employer just delayed leave or also fired, demoted, or cut hours afterward.
What if the leave issue happened more than two years ago?
The intake asks about timing directly and flags claims outside that window so you can weigh a possible limitations problem before booking time.
Can the intake tell FMLA leave apart from an ADA accommodation request?
The opening question is specific to serious health condition, family caregiving, pregnancy, or military-related leave; issues that are really about workplace accommodations route toward the ADA Accommodations intake instead.
What if the caller doesn't know their employer's exact size?
The employer-size question is answered as the caller understands it, so an uncertain answer still gets recorded and scored rather than blocking the intake.
What documents does the intake collect from FMLA callers?
It asks for leave request or denial correspondence, any termination or discipline notice, and records showing hours worked, so you have supporting documents before the consultation.
Turn fmla leave visitors into qualified cases
Give every fmla leave visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.