Joint replacement intake that captures imaging and doctor
Patients tell you which joint hurts most, how much it limits daily activity, and whether a doctor has already recommended surgery — and upload existing X-ray or MRI images before your staff ever picks up the phone.
The exact intake your joint replacement evaluation leads complete
This is the real 7-question guided intake for Joint Replacement Evaluation — the same flow your customers finish before you ever pick up the phone.
What a qualified joint replacement evaluation lead should tell you
An orthopedic intake that identifies which joint is affected, how much it limits daily function, and whether the patient has already tried conservative treatment or received a surgical recommendation — the details a surgeon needs before deciding if a replacement evaluation is warranted.
- Joint Causing Most Concern
- Much Joint Pain Limit
- Already Tried Non-Surgical Treatments
- Have Prior Imaging, Such
- Doctor Previously Recommended Joint
- Soon Have This Evaluation
- Patient, Or Inquiring On
The questions your team needs answered
Every joint replacement evaluation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Which joint is causing the most concern? | Identifies which joint the patient is concerned about so the lead can be routed to the right specialist before staff review the rest of the intake. |
| How much does the joint pain limit your daily activities? | Activity limitation carries the heaviest weight in scoring because it directly reflects how advanced the joint damage likely is. |
| Have you already tried non-surgical treatments such as physical therapy or medication? | A patient who has already tried physical therapy or medication scores higher, since they're further along the care pathway toward a surgical conversation. |
| Do you have prior imaging, such as an X-ray or MRI, of the joint? | Knowing whether imaging already exists helps the practice avoid ordering duplicate scans and gauge case severity before the first visit. |
| Has a doctor previously recommended joint replacement surgery for you? | A prior surgical recommendation from another doctor signals the patient is already close to a decision, so it's weighted heavily toward priority. |
| How soon are you hoping to have this evaluation? | Captures how soon the patient wants to be seen, helping staff sequence scheduling even though the answer isn't part of the numeric score. |
| Are you the patient, or are you inquiring on behalf of someone else? | Flags proxy inquiries so staff know to confirm the actual patient's identity and consent before booking a slot. |
How Cliont scores joint replacement evaluation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Moderate, limits some activities
- Mild, occasional limitation
- Already Tried Non-Surgical Treatments: yes
- Doctor Previously Recommended Joint: yes
Urgency signals
- Severe, limits most activities
See the lead your team receives
Joint Replacement 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 joint replacement evaluation workflows
| Cliont capability | Joint Replacement Evaluation application |
|---|---|
| Conditional branching | Routes knee, hip, shoulder, and other-joint cases (q001) toward the appropriate specialist queue before staff ever open the lead. |
| File upload capture | Collects existing X-ray or MRI images (q004) directly in the intake so staff know what imaging is already on hand. |
| Weighted scoring engine | Weighs completed physical therapy and a prior surgical recommendation (q003, q005) more heavily than a fresh, untreated complaint, surfacing patients closer to a surgical decision first. |
| Proxy inquiry detection | Flags when someone is inquiring on behalf of a patient (q007) so staff confirm identity and consent before booking a slot. |
| CRM routing | Sends high-severity, treatment-experienced joint replacement leads straight into your CRM as scheduling-ready patients rather than raw form submissions. |
Common joint replacement evaluation lead scenarios
Surgeon already recommended surgery
The patient reports severe activity limitation, has already tried physical therapy, and a doctor has previously recommended replacement — the intake surfaces this as a near-ready surgical case.
Still in conservative treatment
Pain is mild to moderate and the patient hasn't yet tried physical therapy or medication, so the intake flags a case that likely needs conservative care before a surgical evaluation makes sense.
Family member inquiring on behalf of patient
The inquiry comes in as 'on behalf of someone else' rather than the patient directly, which changes how staff should confirm identity and consent before booking any slot.
No prior imaging on file
The patient reports severe symptoms but has no existing X-ray or MRI, signaling the practice needs to arrange imaging before or during the first visit rather than assuming it's already available.
Just exploring options
The patient selects the least urgent timeline and hasn't been told surgery is needed, pointing staff toward an informational touchpoint rather than an immediate appointment slot.
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 orthopedics intake templates
Joint Replacement Evaluation lead-intake FAQs
Does the intake ask which joint is affected before booking?
Yes — patients select knee, hip, shoulder, or another joint as the first question, so staff can see the case type and route it to the right specialist before reviewing the rest of the intake.
How does the scoring treat patients who haven't tried physical therapy yet?
A patient who has already tried non-surgical treatment scores higher than one who hasn't, since they're further along the typical care pathway toward a surgical conversation rather than a first-line conservative referral.
What happens if someone fills out the intake for a family member instead of themselves?
The intake captures whether the person is the patient or inquiring on their behalf, so your staff know to confirm the actual patient's identity and consent before scheduling any appointment.
Do patients need to upload imaging before the visit?
The intake asks whether the patient already has an X-ray or MRI and collects those files if available, which helps your team gauge severity and avoid ordering duplicate imaging.
Can the intake tell how soon a patient wants to be seen?
Yes — patients choose a timeline ranging from as soon as possible to just exploring options, which your staff can use to sequence scheduling alongside the severity and treatment-history answers.
Turn joint replacement evaluation visitors into qualified patients
Give every joint replacement evaluation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.