See who caused the injury before the consultation
Ask whether the injury happened on the job, whether medical care was needed, and whether a third party may share fault — then collect medical records and incident reports before the case reaches your CRM.
The exact intake your workplace injuries leads complete
This is the real 7-question guided intake for Workplace Injuries — the same flow your customers finish before you ever pick up the phone.
What a qualified workplace injuries lead should tell you
Injuries sustained on the job or at a workplace where a third party — an employer, coworker, contractor, or equipment maker — may share liability beyond a standard workers' compensation claim.
- Get Hurt While Doing
- Injury Happen In United
- Injury Happen Within Last
- Medical Care Or Miss
- Believe Someone Other Than
- Identify Company Or Person
- Already Signed Final Settlement
The questions your team needs answered
Every workplace injuries intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Did you get hurt while doing your job or at your workplace? | Confirms the injury is actually work-related before any other detail matters for a workplace PI claim. |
| Did the injury happen in the United States? | A "yes" flags a higher-value, higher-urgency lead you’ll want to reach first. |
| Did the injury happen within the last 2 years? | Injuries outside the two-year window raise statute-of-limitations risk that affects whether the case is worth a consultation. |
| Did you need medical care or miss at least one day of work because of the injury? | A "yes" flags a higher-value, higher-urgency lead you’ll want to reach first. |
| Do you believe someone other than you may have caused or contributed to the injury (for example, your employer, a coworker, a contractor, or a defective product)? | Third-party fault is what turns a workplace injury into a viable PI claim rather than a workers' comp-only matter. |
| Can you identify the company or person involved (such as your employer, the job site, or the maker of the equipment/product)? | Being able to name the employer, job site, or product maker determines how quickly a claim can be investigated and pursued. |
| Have you already signed a final settlement or release about this injury? | A signed settlement or release usually closes the door on new representation, so this answer prevents wasted consultation time. |
How Cliont scores workplace injuries leads
Every answer is weighted automatically — no manual review required.
Value signals
- Get Hurt While Doing: yes
- Injury Happen In United: yes
- Injury Happen Within Last: yes
- Medical Care Or Miss: yes
- Believe Someone Other Than: yes
- Identify Company Or Person: yes
Lower-fit signals
- Already Signed Final Settlement: no
See the lead your team receives
Workplace 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 workplace injuries workflows
| Cliont capability | Workplace Injuries application |
|---|---|
| Weighted qualification scoring | Separates viable third-party workplace claims from workers'-comp-only injuries by weighting the fault and employer-identification questions heavily. |
| Lower-fit flagging | Flags any lead who has already signed a final settlement or release about the injury before your team spends time on a consultation. |
| Jurisdiction and timeline checks | Confirms the injury happened in the United States and within the last two years, surfacing statute-of-limitations risk early. |
| Document collection | Prompts for incident reports and medical records tied to the injury and treatment questions, so intake includes evidence, not just answers. |
Common workplace injuries lead scenarios
Third-party fault, recent injury
Injury happened within the last two years, required medical care, and the prospective client believes a contractor or coworker contributed — the intake surfaces this as a high-value lead ready for a consultation.
Already signed a release
The prospective client got hurt at work but has already signed a final settlement or release about the injury, which the intake flags as a lower-fit signal before any time is spent.
Employer unknown or unclear
The injury and third-party fault check out, but the person can't yet name the employer, job site, or equipment maker — the intake still captures the lead but scores it lower until that detail is confirmed.
No third party, comp-only claim
The injury happened on the job and needed medical care, but the prospective client doesn't believe anyone else caused it — the intake distinguishes this from a viable third-party PI case.
Injury outside the window or country
The incident happened more than two years ago or outside the United States, which the intake weighs against the claim before it's routed to your CRM.
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
Workplace Injuries lead-intake FAQs
How does the intake separate a third-party PI case from a workers'-comp-only injury?
The intake asks directly whether the client believes someone other than themselves — an employer, coworker, contractor, or product maker — caused or contributed to the injury, and whether that party can be identified. Leads with no suspected third-party fault score lower, since they're often better suited for a workers' comp claim than a PI matter.
What happens if the prospective client can't name the employer or job site yet?
The intake still records that response and forwards the lead, but it factors the missing identification into the overall score rather than treating it as an automatic disqualifier.
Does the intake catch leads who've already signed a settlement or release?
Yes — it asks whether a final settlement or release has already been signed and weights that answer as a lower-fit signal, since those matters are usually closed to new representation.
Why does the intake ask if the injury happened in the United States?
Jurisdiction affects which laws and courts apply, so the intake confirms the injury occurred in the U.S. before a lead is scored as strong fit for your firm.
What documents does the intake collect for workplace injury leads?
It requests incident or accident reports, medical treatment records, and identifying information for the employer, job site, or equipment involved, so you're reviewing more than a bare narrative before the consultation.
How does the two-year timeframe question affect scoring?
An injury reported within the last two years scores higher, since older injuries raise statute-of-limitations concerns that the intake flags rather than resolves for you.
Turn workplace injuries visitors into qualified cases
Give every workplace injuries visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.