Know which migraine leads need urgent neuro review
Patients answer questions about how long they've had headaches, how often they occur, and whether new neurological symptoms have appeared, so your front desk can see who needs urgent review before a slot is booked.
The exact intake your headache and migraine leads complete
This is the real 6-question guided intake for Headache and Migraine — the same flow your customers finish before you ever pick up the phone.
What a qualified headache and migraine lead should tell you
Intake evaluation for patients with recurring headaches or migraines, capturing how long symptoms have persisted, how often they occur, whether new neurological symptoms have appeared, and what treatments have already been tried.
- Long Have Been Experiencing
- Often Experience These Headaches
- Noticed Any New Or
- Previously Been Diagnosed With
- Already Tried Treatments Such
- This Appointment
The questions your team needs answered
Every headache and migraine intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| How long have you been experiencing these headaches or migraines? | Headaches lasting years versus starting recently shifts how a provider frames the visit, even though duration alone doesn't carry a numeric weight. |
| How often do you experience these headaches or migraines? | Frequency is directly weighted, with daily and several-times-a-week answers scoring highest and pushing the lead toward faster review. |
| Have you noticed any new or worsening neurological symptoms, such as vision changes or weakness? | This is the highest-weighted question in the catalog, since new vision changes or weakness alongside headaches can signal something beyond typical migraine. |
| Have you previously been diagnosed with migraines or another headache condition? | Knowing whether the patient already has a migraine diagnosis lets your team distinguish a first neurological workup from an ongoing management visit. |
| Have you already tried treatments such as medication or lifestyle changes for this condition? | A patient whose current treatment isn't working scores higher than one who hasn't tried anything yet, since it points to an active problem needing a visit sooner. |
| Who is this appointment for? | Knowing whether the appointment is for the patient, a child, or someone else they care for changes what consent and intake steps your staff need to prepare. |
How Cliont scores headache and migraine leads
Every answer is weighted automatically — no manual review required.
Value signals
- Daily
- Several times a week
- About once a week
- Monthly or less often
- Noticed Any New Or: yes
- Yes, but not working well
See the lead your team receives
Migraine Lead - Daily headaches with new neurological symptoms
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 headache and migraine workflows
| Cliont capability | Headache And Migraine application |
|---|---|
| Automated lead scoring | Combines the neurological symptoms answer with headache frequency and treatment-response answers so daily migraines with new symptoms surface above a mild, infrequent case. |
| Conditional intake logic | Adjusts what's asked next based on whether the patient has been previously diagnosed with migraines, separating a first-workup path from a follow-up management path. |
| CRM delivery | Sends who the appointment is for, along with symptom duration and frequency, directly into your CRM so front-desk staff aren't manually re-asking intake questions at booking. |
| Structured field capture | Turns free-text symptom descriptions into standardized answers on duration, frequency, and treatment history that are consistent across every migraine lead. |
Common headache and migraine lead scenarios
Daily headaches with new symptoms
A patient reports daily headaches plus new vision changes or weakness, the two highest-weighted signals in the catalog, so the intake flags this lead as a priority for faster review.
Treatment tried, not working
An existing migraine patient reports weekly episodes and medication that isn't helping, a combination that scores high and points to a treatment-adjustment visit rather than a first workup.
New patient, no treatment yet
Someone with monthly headaches who hasn't tried any treatment answers differently than a long-diagnosed patient, letting your team distinguish a first consult from a management check-in.
Intake filed for a child
When the appointment is for a child or another family member rather than the patient themselves, the intake captures that context upfront so scheduling and consent steps aren't missed.
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 neurology intake templates
Headache and Migraine lead-intake FAQs
How does the intake flag a potential red-flag headache?
The question about new or worsening neurological symptoms such as vision changes or weakness carries the highest weight in the catalog, so a 'yes' answer pushes the lead's score up regardless of how long they've had headaches.
Can the intake tell a new headache patient apart from an established migraine patient?
Yes, the intake asks whether the patient has already been diagnosed with migraines or another headache condition, which lets your team route first-time evaluations differently from ongoing management visits.
Does headache frequency actually change the lead score?
Yes, every frequency option from daily down to monthly carries its own weight, so more frequent headaches contribute more to the overall score even before neurological symptoms are considered.
Can a family member submit the intake on a patient's behalf?
Yes, the intake asks who the appointment is for, including options for a child, another family member, or a patient the submitter cares for, so you know who to prepare records and consent for.
Does the intake ask what treatments a patient has already tried?
Yes, it asks whether the patient has tried medication or lifestyle changes and how well that worked, which helps separate a lead needing a first-line workup from one needing a treatment change.
Is this the same intake used for Seizure Evaluation or Memory and Cognitive Concerns?
No, each neurology subservice in your library, including Seizure Evaluation and Memory and Cognitive Concerns, has its own question set built around what actually matters for that condition.
Turn headache and migraine visitors into qualified patients
Give every headache and migraine visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.