Long-term care intake that captures assets and urgency up front
The intake asks whether care is needed within the next 12 months, whether there are assets or income to protect, and which state the planning falls under — then routes consultation-ready leads with a financial summary straight to your CRM.
The exact intake your long-term care planning leads complete
This is the real 7-question guided intake for Long-Term Care Planning — the same flow your customers finish before you ever pick up the phone.
What a qualified long-term care planning lead should tell you
Long-term care planning covers the legal work of structuring how a nursing home, assisted living, or in-home care stay gets paid for and how a family's assets are protected in the process — the intake needs to know who the care is for, when it's needed, and what there is to protect.
- Help How Pay Long-Term
- Person Needing Living In
- Know Which State Person
- Long-Term Care Needed Now
- Person Have Assets Or
- Person Willing Share Basic
- Person Needing , Or
The questions your team needs answered
Every long-term care planning intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Are you looking for help planning how to pay for long-term care (like a nursing home, assisted living, or in-home care) for yourself or a family member? | This filters out general inquiries that aren't actually about paying for care before any other question is asked. |
| Is the person needing planning currently living in the United States? | US residency is close to a threshold requirement for domestic long-term care and Medicaid planning, so a no answer flags a likely poor fit. |
| Do you know which state the person lives in (or where the planning would be done)? | Long-term care rules are set at the state level, so not knowing the governing state means the consultation can't proceed until that's clarified. |
| Is long-term care needed now or likely within the next 12 months? | How soon care is needed separates urgent placement decisions from early-stage planning, which changes how fast you need to follow up. |
| Does the person have assets or income to protect or plan around (such as a home, savings, retirement, or regular income)? | Whether there are assets or income to protect largely determines whether there's a billable planning engagement here at all. |
| Is the person willing to share basic financial details (assets, income, and any gifts/transfers) so an attorney can advise them? | Willingness to disclose financial details signals whether the person is ready to engage in real planning versus just gathering general information. |
| Are you the person needing planning, or do you have permission to seek help for them (for example, as a spouse, adult child, or authorized representative)? | Confirming the submitter has standing to act for the person needing care avoids booking a consultation you can't actually advance without proper authorization. |
How Cliont scores long-term care planning leads
Every answer is weighted automatically — no manual review required.
Value signals
- Help How Pay Long-Term: yes
- Person Needing Living In: yes
- Know Which State Person: yes
- Long-Term Care Needed Now: yes
- Person Have Assets Or: yes
- Person Willing Share Basic: yes
See the lead your team receives
Long-Term Care Planning 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 long-term care planning workflows
| Cliont capability | Long-Term Care Planning application |
|---|---|
| Conditional branching | If a lead has nothing to protect and confirms care isn't needed soon, the intake can shorten the remaining financial questions instead of pushing a full disclosure request. |
| Weighted lead scoring | Assets, timeline, and residency carry the heaviest weight in this catalog, so a lead with near-term care needs and a home or savings to protect scores well above a distant, asset-light inquiry. |
| CRM routing | Leads that confirm state, timeline, and authority to act are routed to your CRM with those details attached, so your team can prep for a consultation instead of re-asking basic facts. |
| Video intake widget | A family member calling on behalf of a parent can explain the care situation on video, giving you context on the authority question before you decide whether to schedule. |
Common long-term care planning lead scenarios
Care needed within the year
The family reports a nursing home or assisted living placement is likely within 12 months and there's a home or savings to protect — this scores as an urgent, high-value lead.
Early planning, no immediate need
Someone wants to plan ahead but care isn't needed for years — the intake still captures assets and state but flags this as a lower-urgency, still-qualified lead.
Adult child inquiring for a parent
The person filling out the form isn't the one needing care and doesn't yet confirm authority to act on their behalf, so the intake surfaces that permission gap before a consultation gets booked.
No assets to protect
The prospective client has minimal savings or income and answers no when asked if there's anything to protect — this signals the matter may not warrant a paid planning engagement.
Unsure of the governing state
The person doesn't know which state the plan should be filed under, which matters since long-term care and Medicaid rules are state-specific — the intake flags this for clarification 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 estate planning and probate intake templates
Long-Term Care Planning lead-intake FAQs
Can someone fill this out on behalf of a parent or spouse?
Yes — the intake directly asks whether the person submitting the form is the one needing care or has permission to seek help for them, so you can see at a glance whether authority still needs to be confirmed before a consultation.
Does the intake collect exact account balances?
It asks whether the person is willing to share basic financial details such as assets, income, and any gifts or transfers, so an attorney can advise them — it doesn't require exact figures upfront, just willingness to disclose.
How does the intake handle someone who doesn't know their state?
It asks directly whether the person knows which state the planning would be done in, since long-term care and Medicaid eligibility rules vary by state — an unclear answer here is a signal to clarify before booking.
What if care isn't needed for years?
The timeline question captures whether care is needed now or within 12 months versus further out, so you can distinguish urgent placement situations from early-stage planning inquiries without losing either lead.
Does this intake work for planning inquiries related to Medicaid or elder law?
This subservice focuses on paying for long-term care broadly — for pure eligibility or benefits planning, the Medicaid Planning and Elder Law Planning subservices in this library cover those angles more directly.
What happens if the person doesn't currently live in the US?
Residency is asked directly, since US-based long-term care planning generally requires the person to be living in the US — a no answer here is a strong signal the matter may not fit your practice.
Turn long-term care planning visitors into qualified cases
Give every long-term care planning visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.