Which seizure evaluation enquiries deserve appointment time
The intake asks whether this is a first episode or a recurring pattern, when the most recent episode happened, and whether the person already has a seizure diagnosis or is on medication, then collects ER paperwork before the lead reaches your CRM.
The exact intake your seizure evaluation leads complete
This is the real 7-question guided intake for Seizure Evaluation — the same flow your customers finish before you ever pick up the phone.
What a qualified seizure evaluation lead should tell you
A neurology intake for patients who have had one or more seizure-like episodes, capturing episode frequency, timing, prior diagnosis, and medication status to route the case to the right type of visit.
- This Evaluation
- Many Seizure-Like Episodes Has
- Did Most Recent Episode
- Person Already Been Seen
- Person Have Prior Diagnosis
- Person Taking Any Seizure
- Person Authorized Make Medical
The questions your team needs answered
Every seizure evaluation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Who is this evaluation for? | Knowing whether the evaluation is for the patient, their child, or another family member determines which consent and authorization checks the intake needs to run next. |
| How many seizure-like episodes has the person had? | The weighted options for one episode, multiple episodes, or uncertainty directly reflect how much clinical concern the case warrants before a visit is even booked. |
| When did the most recent episode occur? | Segments the lead so you can route, price, and prioritize it correctly. |
| Has the person already been seen in an emergency room for this? | An existing ER visit signals a workup may already be underway elsewhere, which matters for how the case is prioritized against a first-contact case. |
| Does the person have a prior diagnosis of a seizure disorder or epilepsy? | A prior seizure disorder diagnosis separates a new diagnostic workup from a returning epilepsy patient, which typically need different appointment types. |
| Is the person currently taking any seizure medication? | Current medication status indicates whether the visit is likely a treatment review rather than an initial diagnostic evaluation. |
| Are you the person authorized to make medical appointments for the patient? | The large gap between the yes and no weights reflects the real cost of booking an appointment for someone who isn't authorized to schedule it on the patient's behalf. |
How Cliont scores seizure evaluation leads
Every answer is weighted automatically — no manual review required.
Value signals
- One episode
- Multiple episodes
- Not sure if it was a seizure
- Person Authorized Make Medical: yes
See the lead your team receives
Seizure 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 seizure evaluation workflows
| Cliont capability | Seizure Evaluation application |
|---|---|
| Weighted scoring | Combines episode frequency (one, multiple, or uncertain) with the authorization answer so genuine new or recurring cases outrank unauthorized or incomplete submissions. |
| Conditional branching | Surfaces the authorization question only when the evaluation is booked for a child or another family member, keeping the self-booking flow shorter. |
| Document upload | Collects ER discharge paperwork when the patient indicates they were already seen, so your team can review prior workup instead of duplicating it. |
| CRM routing | Sends qualified seizure leads to your CRM with episode timing, prior diagnosis, and medication status attached for the scheduling team to review before booking. |
Common seizure evaluation lead scenarios
First unexplained episode
An adult reports one episode, no prior diagnosis, and isn't sure it was actually a seizure. The intake flags this as a new-onset workup that needs a full evaluation slot.
Parent booking for a child
A parent selects 'my child' and reports multiple episodes with a recent ER visit. The intake surfaces the authorization question to confirm the parent can book on the child's behalf.
Established epilepsy follow-up
The patient already has a seizure diagnosis, takes medication, and had a recurring episode over a month ago. This reads as a medication-management visit rather than a new diagnostic workup.
Family member without authorization
Someone books on behalf of another family member but isn't the person authorized to make appointments. The heavily weighted authorization answer flags this before a slot is confirmed.
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
Seizure Evaluation lead-intake FAQs
How does the intake separate a brand-new seizure workup from an existing epilepsy follow-up?
It checks whether the person already has a seizure disorder diagnosis and whether they're currently on medication, so a recurring epilepsy patient isn't routed the same way as someone reporting their first episode.
Does the intake account for a parent filling this out for their child?
Yes, the first question asks who the evaluation is for, and if a family member is booking, the intake also checks whether they're authorized to make appointments for that patient.
What if the patient already went to the ER for this episode?
The intake asks directly whether the person has already been seen in an emergency room, so your team knows if a workup has already started elsewhere before scheduling a duplicate visit.
Can the intake handle someone who isn't sure it was even a seizure?
Yes, 'not sure if it was a seizure' is one of the episode-count options and carries meaningful weight, since ambiguous presentations still warrant an evaluation rather than being screened out.
What happens if the person filling out the form isn't authorized to book for the patient?
The authorization question is weighted heavily against a 'no' answer, so unauthorized submissions surface as lower priority instead of consuming an appointment slot the requester can't actually confirm.
Does this intake overlap with your headache or memory concern intakes?
No, seizure evaluation is a separate catalog from Headache and Migraine and Memory and Cognitive Concerns, so episodes described as seizure-like stay on this pathway rather than getting mixed into an unrelated intake.
Turn seizure evaluation visitors into qualified patients
Give every seizure evaluation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.