Know which dry eye treatment leads are worth appointment time
Patients report symptom duration, current symptoms like burning or light sensitivity, and whether they've already tried OTC drops, then upload a photo of the affected eye and their medication list before a slot is booked.
The exact intake your dry eye treatment leads complete
This is the real 6-question guided intake for Dry Eye Treatment — the same flow your customers finish before you ever pick up the phone.
What a qualified dry eye treatment lead should tell you
Evaluation and management of chronic eye dryness, irritation, or discomfort, qualified by symptom duration, prior treatment attempts, existing diagnosis, and contributing factors like contact lens wear or past eye surgery.
- Long Have Been Experiencing
- Already Tried Over- -Counter
- Eye Care Provider Ever
- Symptoms Experiencing
- Wear Contact Lenses Regularly
- Had Any Eye Surgery
The questions your team needs answered
Every dry eye treatment intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| How long have you been experiencing dry eye symptoms? | Symptoms lasting more than six months signal a chronic case that needs a dedicated workup rather than a quick recheck. |
| Have you already tried over-the-counter eye drops or artificial tears for this? | Knowing whether OTC drops have already been tried tells staff if the patient has exhausted first-line therapy and may be ready for advanced treatment. |
| Has an eye care provider ever diagnosed you with dry eye disease? | An existing diagnosis is weighted higher than no diagnosis, since it signals a returning, better-characterized case rather than a fresh workup. |
| Which symptoms are you currently experiencing? | Each selected symptom carries its own weight, so blurry or fluctuating vision raises the score more than a milder symptom like excess tearing alone. |
| Do you wear contact lenses regularly? | Contact lens wear affects which drops or procedures are appropriate, so flagging it upfront helps staff plan the visit correctly. |
| Have you had any eye surgery in the past? | A history of eye surgery can point to surgically induced dry eye, which often follows a different treatment pathway than primary dry eye disease. |
How Cliont scores dry eye treatment leads
Every answer is weighted automatically — no manual review required.
Value signals
- Eye Care Provider Ever: yes
- Burning or stinging
- Redness
- Blurry or fluctuating vision
- Excess tearing
- Feeling of something in the eye
See the lead your team receives
Dry Eye Treatment 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 dry eye treatment workflows
| Cliont capability | Dry Eye Treatment application |
|---|---|
| Weighted symptom scoring | Each symptom selected in the multi-choice list (burning, redness, blurry vision, light sensitivity, and more) carries its own weight, so patients with multiple higher-severity symptoms are scored above those with a single mild symptom. |
| Prior diagnosis weighting | A confirmed dry eye diagnosis from an eye care provider is weighted higher than no diagnosis, letting your team prioritize returning or established cases in the queue. |
| Pre-visit uploads | Collecting a photo of the affected eye and a current medication list before booking helps prevent a slot being reserved for a patient whose case turns out to need a different evaluation. |
| CRM routing with scored context | Qualified dry eye leads arrive in your CRM with symptom duration, prior treatment history, and contact lens or surgery flags already attached, so staff aren't re-asking basic history at check-in. |
Common dry eye treatment lead scenarios
Diagnosed patient not improving on drops
A previously diagnosed patient reports symptoms lasting more than six months, has already tried OTC drops, and lists blurry vision plus light sensitivity — the intake surfaces this as a high-value case ready for advanced treatment options.
New symptomatic contact lens wearer
A regular contact lens wearer reports recent burning and redness with no prior diagnosis, flagging a case where lens wear needs to be factored into the treatment plan before scheduling.
Post-surgical dryness follow-up
A patient with a history of eye surgery reports longer-term dryness without having tried drops yet, distinguishing a likely surgically induced case from primary dry eye disease.
Vague, single-symptom, uncertain onset
A patient selects only excess tearing, isn't sure how long symptoms have lasted, and has no diagnosis — the intake captures this as a lighter-weight case that may need more questioning 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 ophthalmology intake templates
Dry Eye Treatment lead-intake FAQs
Does the intake ask if patients have already tried eye drops?
Yes, the form asks whether the patient has already tried over-the-counter artificial tears, which helps your team see whether first-line therapy has been exhausted before the visit.
How does the intake treat contact lens wearers differently?
Contact lens use is captured directly in the intake so staff know in advance that lens-compatible drops or treatment adjustments may be needed, rather than discovering it at check-in.
Can the intake flag dry eye caused by prior eye surgery?
Yes, the intake asks about prior eye surgery, which helps distinguish surgically induced dry eye from primary dry eye disease so it can be routed to the right treatment pathway.
How does the intake score a patient's symptom list?
Each symptom in the multi-select list carries its own weight, so a patient reporting blurry or fluctuating vision scores higher than one reporting only excess tearing, reflecting the real difference in severity.
Does an existing dry eye diagnosis change the lead score?
Yes, a prior diagnosis from an eye care provider carries a higher weight than no diagnosis, since it signals an established case rather than a fresh workup.
What happens if a patient's symptoms sound more urgent than routine dry eye?
Acute pain or sudden vision changes are better suited to the Urgent Eye Problem intake, and this dry eye form is built for chronic, ongoing symptoms rather than acute presentations.
Turn dry eye treatment visitors into qualified patients
Give every dry eye treatment visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.