Skin lesion intake that captures symptom changes up front
Ask patients about recent changes in a spot's size or color, whether it's painful or bleeding, and how soon they want to be seen, then collect close-up photos before anything lands on your calendar.
The exact intake your mole and skin lesion evaluation leads complete
This is the real 6-question guided intake for Mole and Skin Lesion Evaluation — the same flow your customers finish before you ever pick up the phone.
What a qualified mole and skin lesion evaluation lead should tell you
An intake process for patients requesting evaluation of a mole or skin lesion, capturing what changed, associated symptoms, and how urgently they want to be seen so staff can prioritize genuine screening candidates.
- Noticed Any Recent Change
- Many Spots Or Lesions
- Spot Painful, Itchy, Bleeding,
- This Spot Been Evaluated
- Main Reason This Evaluation
- Soon Be Seen
The questions your team needs answered
Every mole and skin lesion evaluation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Have you noticed any recent change in the size, shape, color, or texture of the spot? | A reported change in size, shape, color, or texture is the strongest single indicator that a spot warrants prompt clinical review rather than a routine visit. |
| How many spots or lesions would you like evaluated? | Knowing whether one spot or many are involved lets staff allocate the right amount of appointment time before the patient arrives. |
| Is the spot painful, itchy, bleeding, or crusting? | Pain, itching, bleeding, or crusting alongside a visual change raises the likelihood the spot needs closer clinical attention. |
| Has this spot been evaluated by a healthcare provider before? | Whether a provider has already seen the spot helps distinguish a first-time concern from a patient returning for a second opinion or follow-up. |
| What is the main reason for this evaluation? | The stated reason for the visit separates a targeted concern from a routine full-skin check, which affects how the visit should be scheduled. |
| How soon are you hoping to be seen? | How soon the patient wants to be seen signals how much scheduling flexibility they have, independent of the clinical urgency itself. |
How Cliont scores mole and skin lesion evaluation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Noticed Any Recent Change: yes
- Spot Painful, Itchy, Bleeding,: yes
- As soon as possible
- Within a few weeks
- Flexible, no rush
See the lead your team receives
Mole and Skin Lesion Evaluation Lead
From first click to qualified lead
Follow patients and caregivers 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 visit
Smart questions adapt to their visit and capture the full scope.
They share details
Symptoms, history, and documents come attached before the visit.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for mole and skin lesion evaluation workflows
| Cliont capability | Mole And Skin Lesion Evaluation application |
|---|---|
| Automated lead scoring | Combines the recent-change, symptom, and urgency-to-be-seen answers so a changing, bleeding lesion with a request to be seen soon outranks a routine check in your queue. |
| Conditional question logic | The number of spots the patient wants evaluated can shift how much detail and how many photos the intake requests before the case reaches your CRM. |
| Photo capture widget | Collects close-up and wider-context images of the lesion so clinical staff can see what changed before the patient is booked in. |
| CRM lead routing | Sends the reason for evaluation, prior-evaluation status, and urgency answer along with the lead so front desk staff don't have to re-ask basic triage questions at check-in. |
Common mole and skin lesion evaluation lead scenarios
Changing mole, wants urgent look
Patient reports a recent change in size or color plus bleeding or crusting and wants to be seen as soon as possible — the intake flags this as a high-priority screening candidate.
Routine check, no concerns
Patient selects routine skin check with no reported change and flexible timing, letting staff schedule it as a standard visit rather than an urgent slot.
Multiple new spots flagged
Patient wants a few spots evaluated, marks the reason as a new spot of concern, and has never had it looked at by a provider — the intake captures spot count so staff know to book extra time.
Follow-up on prior evaluation
Patient indicates the spot was already evaluated by a provider and this is a follow-up, which routes differently than a first-time concern even if urgency is similar.
Itchy spot, no visible change
Patient reports itching or crusting but no change in size, shape, or color — a mixed signal the intake still weighs toward evaluation given the symptom question's weight.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book visits
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 dermatology intake templates
Mole and Skin Lesion Evaluation lead-intake FAQs
How does the intake flag a mole that needs urgent attention?
It weighs whether the patient reports a recent change in size, shape, color, or texture together with symptoms like bleeding or crusting and their stated urgency to be seen — a patient answering yes to both plus wanting the soonest slot scores highest.
What happens if a patient wants several spots checked at once?
The intake asks how many spots or lesions the patient wants evaluated, so your team can see up front whether to plan for a single-spot visit or a longer full-skin check.
Does the intake ask if a provider has already looked at the spot?
Yes, it asks whether the spot has been evaluated before, which helps staff distinguish a new concern from a returning patient checking in on something already on file.
Can the intake tell a routine skin check apart from a specific worry?
It asks for the main reason for the evaluation — a new spot of concern, an existing spot that changed, a routine check, or a follow-up — so front desk staff know the context before the patient arrives.
What photos does the intake collect from patients?
It requests a close-up photo of the lesion and a wider shot showing surrounding skin for scale, so the clinical team has visual context before the appointment.
How is this different from the Skin Cancer Screening intake?
This intake is built around a single spot or a handful of spots a patient is worried about, while Skin Cancer Screening covers broader full-body check requests — the two share the CRM destination but ask different qualifying questions.
Turn mole and skin lesion evaluation visitors into qualified patients
Give every mole and skin lesion evaluation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.