Burn injury intake that captures cause, liability, and treatment up
Cliont's burn injury intake asks whether the burn happened in the U.S. within the last two years, who may be responsible, and whether the client received emergency treatment or skin grafts — then routes scarring photos and medical records straight to your CRM.
The exact intake your burn injuries leads complete
This is the real 7-question guided intake for Burn Injuries — the same flow your customers finish before you ever pick up the phone.
What a qualified burn injuries lead should tell you
A physical burn from fire, hot liquid or steam, chemicals, electricity, or an explosion, where the intake needs to confirm how and where it happened, whether a third party may be responsible, and how severe the medical outcome was.
- Suffer Burn Injury (Such
- Burn Happen In United
- Burn Happen Within Last
- Someone Else ( Person,
- Identify Who May Be
- Get Medical Care Burn,
- Burn Cause Any These:
The questions your team needs answered
Every burn injuries intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Did you suffer a burn injury (such as from fire, hot liquids/steam, chemicals, electricity, or an explosion)? | Confirms an actual burn injury occurred before any liability or severity questions are asked, filtering out unrelated inquiries at the door. |
| Did the burn happen in the United States? | Establishes U.S. jurisdiction, which determines whether the incident falls within a firm's practice territory. |
| Did the burn happen within the last 2 years? | Flags how close the case may be to a statute-of-limitations deadline, which directly affects viability. |
| Was someone else (a person, business, landlord, employer, or product maker) possibly responsible for what caused the burn? | Third-party responsibility is the core requirement for a personal injury claim rather than a purely accidental injury. |
| Can you identify who may be responsible (or the product/property involved)? | Whether the responsible party or product is identifiable affects how easily the case can be investigated and proven. |
| Did you get medical care for the burn, or do you still have symptoms or scarring? | Documented medical care establishes the injury on record, which matters for both diagnosis and damages. |
| Did the burn cause any of these: emergency treatment, hospitalization, surgery/skin grafts, infection, permanent scarring, missed work, or ongoing pain? | Markers like hospitalization, skin grafts, or permanent scarring indicate a higher-value case that warrants faster attorney attention. |
How Cliont scores burn injuries leads
Every answer is weighted automatically — no manual review required.
Value signals
- Suffer Burn Injury (Such: yes
- Burn Happen In United: yes
- Burn Happen Within Last: yes
- Someone Else ( Person,: yes
- Identify Who May Be: yes
- Get Medical Care Burn,: yes
Urgency signals
- Burn Cause Any These:
See the lead your team receives
Burn Injury 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 burn injuries workflows
| Cliont capability | Burn Injuries application |
|---|---|
| Weighted scoring engine | Runs the seven burn-injury questions through their assigned weights so a burn with clear liability, U.S. jurisdiction, and hospitalization outranks a minor at-home burn with no identifiable responsible party. |
| Photo and document upload | Collects photos of the burn or scarring plus medical records at intake, so your team can gauge injury severity before the client is on the phone. |
| CRM routing by score band | Sends burns with hospitalization, surgery, or skin grafts into your CRM as high-priority cases while lower-scoring, untreated burns land in a separate queue. |
| Conditional follow-up logic | Prompts for who caused the burn and whether the responsible party or product can be identified only after the client confirms someone else may be at fault, keeping the flow relevant to liability-based burn claims. |
Common burn injuries lead scenarios
Workplace chemical burn, employer at fault
A faulty machine or missing safety gear caused the burn, and the client can name the employer or equipment involved. The intake flags the identifiable responsible party and pushes the case forward as a strong liability match.
Defective product caused the burn
A malfunctioning appliance, e-cigarette, or heating device caused the injury, and the client kept the item or knows the brand. Answers around identifying the product route this as a product-liability lead rather than a premises claim.
Restaurant scald requiring hospitalization
Hot liquid or steam from a business caused a burn severe enough to require ER treatment or skin grafts. The urgency signal from hospitalization and surgery pushes this straight to the top of the queue.
Old burn, past the two-year mark
The injury happened more than two years ago, which drags the score down under the timing question even if liability looks clear. The intake still captures the facts so the firm can quickly assess statute exposure before offering a consultation.
Minor burn treated at home
The client never sought medical care and has no lasting symptoms or scarring. Without documented treatment, the case scores lower and can be routed for a quick screen rather than a full consultation.
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 personal injury intake templates
Burn Injuries lead-intake FAQs
How does the intake handle burns that happened more than two years ago?
The timing question is weighted so an older burn scores lower, since statute-of-limitations exposure varies by state. The lead still comes through with the date captured so your team can make the call before booking a consultation.
Can the intake tell the difference between a product-liability burn and a premises-liability burn?
The catalog asks who or what may be responsible and whether the client can identify that party or product, so a defective appliance and a negligent property owner surface as distinct fact patterns rather than one generic 'someone else's fault' answer.
What happens if the prospective client never got medical treatment for the burn?
The medical care question and the severity question (hospitalization, grafts, scarring, missed work) both carry meaningful weight, so a burn with no documented treatment and no lasting symptoms scores lower and can be triaged separately from serious injury leads.
Does the intake ask where the burn happened?
Yes — the catalog confirms whether the burn occurred in the United States, which matters for jurisdiction, and that answer factors directly into the lead's score.
How are hospitalizations and skin grafts prioritized against a minor burn?
The severity question covering emergency treatment, hospitalization, surgery/grafts, infection, scarring, missed work, or ongoing pain is the urgency signal in the catalog, so those cases are flagged for faster follow-up than a burn with no lasting effects.
What photos or documents does the intake actually collect?
It's set up to collect photos of the burn or resulting scarring and any medical records or discharge paperwork the client has, so your team reviews visual and clinical evidence before the first call.
Turn burn injuries visitors into qualified cases
Give every burn injuries visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.