Surgical error intake that flags cases inside the filing window
The intake asks whether the harm came from a surgical mistake or a disclosed risk, whether it required additional treatment, and whether the hospital or surgeon can be identified — then sends qualified matters to your CRM with medical records attached.
The exact intake your surgical errors leads complete
This is the real 7-question guided intake for Surgical Errors — the same flow your customers finish before you ever pick up the phone.
What a qualified surgical errors lead should tell you
A claim arising from a mistake made during surgery — such as operating on the wrong site, leaving a foreign object, or a technical error — that caused a new or worsened injury, as distinct from a known risk the patient was already told about.
- Surgical Error Happen In
- Problem Happen During Surgery
- Suffer New Or Worsened
- Injury Additional Treatment, Another
- Injury Cause Significant Costs,
- Surgery Or Discovery Error
- Identify Hospital, Clinic, Or
The questions your team needs answered
Every surgical errors intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Did the surgical error happen in the United States? | Jurisdiction determines whether the matter fits a US-based practice at all, so a "no" here should route the lead out early. |
| Did the problem happen during surgery or because of a surgical mistake (not just a known risk that was explained to you)? | This is the core liability question — a complication that was a disclosed risk rather than a mistake is unlikely to support a malpractice claim. |
| Did you suffer a new or worsened injury after the surgery? | A "yes" flags a higher-value, higher-urgency lead you’ll want to reach first. |
| Did the injury require additional treatment, another surgery, a longer hospital stay, or ongoing care? | Needing another surgery, longer hospitalization, or ongoing care is a strong indicator of provable damages worth pursuing. |
| Did the injury cause significant costs, lost income, long-term problems, disability, or death? | Significant costs, lost income, disability, or death are what typically justify the time and expense of a surgical error case. |
| Did the surgery or the discovery of the error happen within the last 3 years? | Whether the surgery or discovery happened within the last 3 years is a rough proxy for whether the claim may still be within a usable filing period. |
| Can you identify the hospital, clinic, or surgeon involved? | Being able to name the hospital, clinic, or surgeon makes it far easier to obtain records and confirm the claim before committing consultation time. |
How Cliont scores surgical errors leads
Every answer is weighted automatically — no manual review required.
Value signals
- Surgical Error Happen In: yes
- Problem Happen During Surgery: yes
- Suffer New Or Worsened: yes
- Injury Additional Treatment, Another: yes
- Injury Cause Significant Costs,: yes
- Surgery Or Discovery Error: yes
See the lead your team receives
Surgical Error 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 surgical errors workflows
| Cliont capability | Surgical Errors application |
|---|---|
| Weighted scoring | Answers about a new or worsened injury, additional treatment, and significant costs or disability carry the heaviest weights, so catastrophic surgical outcomes surface above minor complications automatically. |
| Conditional lead flagging | A "no" on the surgical-mistake question (known risk, not an error) is scored low enough to separate it from genuine malpractice inquiries without needing manual review. |
| Document collection | Medical records tied to the surgery and follow-up care are requested during intake so operative details are on file before the prospective client reaches a consultation. |
| CRM routing | Only surgical error leads that clear the 3-year window, identify a hospital or surgeon, and show real injury severity are routed to your CRM as qualified matters. |
Common surgical errors lead scenarios
Recent complication, provider identified
Surgery happened within the last 3 years, the patient names the hospital and surgeon, and a new injury required a second procedure — the intake routes this straight through as high value.
Known risk, not a mistake
The complication matches a risk the patient was told about beforehand, so the intake flags the answer to the surgical-mistake question as a poor fit before a consultation is offered.
Old surgery, timing unclear
The patient can't confirm whether the surgery or discovery of the error was within 3 years, so the lead scores lower pending a timing check rather than being auto-qualified.
Catastrophic outcome, ongoing care
The injury caused disability and ongoing care needs plus significant lost income, pushing the severity and damages questions to their highest weight in the score.
Can't name the hospital or surgeon
The prospective client is unsure which facility or surgeon was responsible, so the intake still captures everything else but the file is marked for a follow-up before any consultation is booked.
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
Surgical Errors lead-intake FAQs
How does the intake tell a real surgical error from a disclosed risk?
One catalog question asks directly whether the problem happened because of a mistake during surgery rather than a risk that was explained beforehand, and a "no" answer carries a much lower weight so the lead scores as a poor fit rather than a probable malpractice case.
Does the intake check whether the case is still within a usable filing period?
Yes — it asks whether the surgery or the discovery of the error happened within the last 3 years, which lets you deprioritize likely time-barred inquiries before you spend consultation time on them.
What happens if the prospective client doesn't know which hospital or surgeon was involved?
The intake still asks that question and records the answer as-is; a "no" lowers the score slightly but doesn't disqualify the lead, since the identity of the defendant is often confirmed later with records.
Can the intake screen out surgeries that happened outside the United States?
Yes, one question confirms whether the surgical error happened in the United States, and a "no" answer carries a much lower weight since jurisdiction affects whether the matter fits your practice.
How does injury severity change the lead score for surgical error cases?
Answers about additional treatment, lost income, disability, or death all carry heavy weights, so a case involving another surgery or a permanent injury scores meaningfully higher than one with a minor, resolved complication.
What documents does the intake collect from surgical error prospects?
The intake is built to collect medical records and related documentation from the surgery and follow-up care alongside the qualification questions, so your team has evidence to review before the first consultation.
Turn surgical errors visitors into qualified cases
Give every surgical errors visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.