IBD intake that captures flare-up and symptom severity up front
Patients share whether they have a confirmed IBD diagnosis, which symptoms like rectal bleeding or weight loss are present, and their current care stage, plus recent lab or endoscopy reports, before anything lands in your CRM.
The exact intake your inflammatory bowel disease leads complete
This is the real 5-question guided intake for Inflammatory Bowel Disease — the same flow your customers finish before you ever pick up the phone.
What a qualified inflammatory bowel disease lead should tell you
Qualification for patients managing or seeking evaluation for Crohn's disease, ulcerative colitis, or other inflammatory bowel conditions, based on diagnosis status, active symptoms, and current stage of care.
- Already Been Diagnosed With
- This Care
- Symptoms Or Concerns Present
- Help Finding Gastroenterologist Ongoing
- Current Stage Care
The questions your team needs answered
Every inflammatory bowel disease intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Have you already been diagnosed with an inflammatory bowel condition such as Crohn's disease or ulcerative colitis? | A confirmed diagnosis separates active IBD management from an undiagnosed case that needs a different evaluation path. |
| Who is this care for? | Knowing whether the care is for a child, self, or another family member changes scheduling and consent needs. |
| Which symptoms or concerns are currently present? | Rectal bleeding and unexplained weight loss carry the highest symptom weights and typically indicate a case needing faster review than fatigue alone. |
| Do you currently need help finding a gastroenterologist for ongoing IBD care? | This answer distinguishes patients actively trying to book ongoing care from those only researching. |
| What is the current stage of your care? | Care stage such as flare-up or second opinion signals how urgently the practice should respond compared to routine follow-up. |
How Cliont scores inflammatory bowel disease leads
Every answer is weighted automatically — no manual review required.
Value signals
- Already Been Diagnosed With: yes
- Abdominal pain
- Diarrhea
- Rectal bleeding
- Unexplained weight loss
- Fatigue
See the lead your team receives
Inflammatory Bowel Disease 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 inflammatory bowel disease workflows
| Cliont capability | Inflammatory Bowel Disease application |
|---|---|
| Weighted scoring engine | Weights rectal bleeding and weight loss higher than fatigue alone, so active flare symptoms surface above routine check-in requests. |
| Branching intake logic | Adjusts follow-up based on the care-stage answer, so a 'flare-up' response and a 'second opinion' response don't collect the same information. |
| File upload capture | Collects lab results or endoscopy reports at intake so a gastroenterologist has history on hand before the first visit. |
| Caregiver-aware fields | Flags when the care recipient is a child or another family member so pediatric IBD cases route differently than adult self-referrals. |
| CRM sync | Sends diagnosis status, symptom summary, and care stage together into your CRM instead of a raw form submission. |
Common inflammatory bowel disease lead scenarios
Newly diagnosed, needs a GI
Patient confirms a recent Crohn's or colitis diagnosis and says yes to needing help finding ongoing care, which the intake flags for prompt scheduling.
Active flare with bleeding
Symptom selection includes rectal bleeding and abdominal pain alongside a 'flare-up' care stage, pushing the weighted score toward the top of the queue.
Second opinion on management
An already-diagnosed patient in ongoing management selects the second-opinion stage with only mild symptoms like fatigue, producing a different priority mix than an active flare.
Parent inquiring for a child
The care-recipient question is answered 'My child' alongside unexplained weight loss, which the intake treats differently from a self-reported adult case.
Undiagnosed, general questions
No prior diagnosis is reported and the symptom question is answered 'no symptoms, seeking general guidance,' scoring lower than a confirmed or symptomatic case.
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 gastroenterology intake templates
Inflammatory Bowel Disease lead-intake FAQs
How does the intake separate IBD leads from IBS or general digestive symptom leads?
The IBD intake opens with a direct diagnosis question and a symptom list weighted toward rectal bleeding, weight loss, and diarrhea, which are specific to inflammatory conditions. Patients without a diagnosis or matching symptoms are better suited to the Irritable Bowel Syndrome or Digestive Symptoms intake instead.
What happens when a patient reports rectal bleeding or unexplained weight loss?
Those two answers carry the highest weights in the symptom question, so a patient selecting either is scored higher than one reporting fatigue alone. That lead is routed to your CRM with those symptoms visible before you decide how quickly to respond.
Can the intake tell us if someone is filling this out for a child or another family member?
Yes, the 'who is this care for' question captures myself, my child, or another family member, so pediatric or dependent-care cases are visible before you schedule.
What if a patient hasn't been diagnosed yet but suspects IBD?
The diagnosis question and the 'seeking a diagnosis' care-stage option both allow for this, and the lead is scored lower than a confirmed diagnosis but still captured for evaluation rather than routed to the Abdominal Pain intake by default.
Does the intake distinguish a flare-up from routine ongoing management?
The care-stage question includes flare-up, ongoing management, newly diagnosed, and second opinion as separate options, which changes how the lead should be prioritized in your CRM.
What documents can patients attach during intake?
Patients can upload recent lab results, colonoscopy or endoscopy reports, and notes on symptom frequency so your team has clinical context before the first appointment.
Turn inflammatory bowel disease visitors into qualified patients
Give every inflammatory bowel disease visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.