Turn X-ray enquiries into appointment-ready leads
Patients tell you the body area being imaged, whether they have a doctor's referral, and how urgent the exam is, then upload their referral document, so your team can confirm eligibility before a slot is booked.
The exact intake your x-ray leads complete
This is the real 6-question guided intake for X-Ray — the same flow your customers finish before you ever pick up the phone.
What a qualified x-ray lead should tell you
A diagnostic imaging exam using low-dose radiation to produce images of bones, joints, or internal structures, ordered to investigate injury, pain, or a known condition.
- Area Body X-Ray
- Have Doctor'S Order Or
- Soon X-Ray Done
- Main Reason This X-Ray
- Patient Able Travel Imaging
- There Possibility Pregnancy Patient
The questions your team needs answered
Every x-ray intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What area of the body needs the X-ray? | The body area determines which equipment and technologist the lead should be routed to before it reaches scheduling. |
| Do you have a doctor's order or referral for this X-ray? | A confirmed doctor's order is one of the strongest indicators of a ready-to-book, clinically appropriate lead, and is weighted accordingly. |
| How soon do you need the X-ray done? | The stated timeline separates same-day emergency requests from patients with no urgency, letting staff triage the queue. |
| What is the main reason for this X-ray? | Segments the lead so you can route, price, and prioritize it correctly. |
| Is the patient able to travel to an imaging facility? | If the patient can't travel to the facility, that logistics gap needs resolving before any appointment is offered. |
| Is there a possibility of pregnancy for the patient? | A possible pregnancy on an abdomen or spine order needs review before scheduling, so it's captured as its own signal rather than folded into the reason for the visit. |
How Cliont scores x-ray leads
Every answer is weighted automatically — no manual review required.
Value signals
- Have Doctor'S Order Or: yes
- Within a few days
- Within a couple of weeks
- No specific timeline
- Patient Able Travel Imaging: yes
Urgency signals
- Emergency, within hours
See the lead your team receives
X-Ray 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 x-ray workflows
| Cliont capability | X-Ray application |
|---|---|
| Automated scoring | Weights whether the patient has a doctor's order, how soon they need the exam, and whether they can travel to the facility, so emergency chest or limb requests with a referral surface above routine, no-timeline enquiries. |
| Safety flagging | Surfaces the pregnancy-possibility answer on abdomen or spine requests separately from limb or dental exams, so staff review it before a slot is confirmed. |
| Body-area routing | Uses the body-area answer to direct chest, limb, spine, abdomen, or dental requests toward the right technologist or machine before the lead reaches your CRM. |
| Document capture | Collects the referral or order document at intake so it's attached to the lead record instead of arriving separately by fax or email. |
Common x-ray lead scenarios
Emergency trauma X-ray
A patient with a recent injury selects an emergency timeline and flags chest or limb imaging, which pushes the lead to the top of the queue for same-day review.
Referred by a physician
The patient has a doctor's order, no rush on timeline, and can travel to the facility, giving a straightforward lead your team can slot into routine scheduling.
Self-referred, no order on file
No doctor's referral is on hand and the reason given is ongoing pain rather than trauma, so the lead is captured but scored lower until an order is confirmed.
Possible pregnancy on an abdomen order
An abdomen or spine X-ray request where pregnancy can't be ruled out gets flagged distinctly from a chest or limb request, so staff can address it before any slot is offered.
Patient can't travel in
The patient indicates they're unable to travel to an imaging facility, which surfaces a mobility or logistics issue your team needs to resolve before booking.
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 diagnostic imaging intake templates
X-Ray lead-intake FAQs
How does the intake handle a patient who might be pregnant?
The intake asks directly whether pregnancy is a possibility, with a Not applicable option for cases like limb or dental X-rays. That answer is captured alongside the body area so your team can review it before confirming any abdomen or spine exam.
Do patients need a doctor's referral to submit an enquiry?
No. The referral question is one of the intake fields, not a gate, so self-referred patients can still submit their request. Having a confirmed referral simply weights the lead higher, since it's a stronger indicator of a ready-to-book patient.
Can the intake tell an emergency chest X-ray apart from a routine one?
Yes, the timeline question captures whether the need is within hours, a few days, a couple of weeks, or no specific timeline, and that answer feeds directly into the lead's score.
What happens if a patient says they can't travel to our facility?
That answer is captured as part of the intake so your staff can see it before scheduling, rather than discovering a mobility or transport issue after a slot has already been offered.
Does the intake ask which body part needs imaging?
Yes, patients select the area, such as chest, limb or joint, spine, abdomen, or dental/jaw, so the lead arrives in your CRM already routed toward the right equipment and technologist.
Can we require a referral document upload before the lead is scored?
You can collect a referral or order document as part of the intake, and it's stored with the lead so staff can verify it alongside the referral question answer rather than chasing paperwork afterward.
Turn x-ray visitors into qualified patients
Give every x-ray visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.