Turn work injury enquiries into appointment-ready patients
Ask every work injury enquiry whether they have a physician referral, whether a workers' comp claim is open or pending, and how the injury limits daily function, then route only appointment-ready patients to your CRM.
The exact intake your work injury rehabilitation leads complete
This is the real 7-question guided intake for Work Injury Rehabilitation — the same flow your customers finish before you ever pick up the phone.
What a qualified work injury rehabilitation lead should tell you
Physical therapy treatment for injuries sustained on the job, where eligibility depends on physician referral status, workers' compensation claim status, and how severely the injury limits daily function.
- This Injury Sustained At
- Area Body Was Injured
- Have Physician Referral Or
- Treatment Being Managed Through
- Current Level Daily Function
- Did This Work Injury
- Already Started Physical Therapy
The questions your team needs answered
Every work injury rehabilitation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Was this injury sustained at work or on the job? | Whether the injury happened at work determines the billing pathway and carries the highest weight in the score, distinguishing occupational cases from general PT enquiries. |
| Which area of the body was injured? | Segments the lead so you can route, price, and prioritize it correctly. |
| Do you have a physician referral or prescription for physical therapy? | A physician referral is often required before treatment can be billed, so its presence or absence is a strong indicator of how close the patient is to being booking-ready. |
| Is your treatment being managed through a workers' compensation claim? | Claim status tells staff whether to expect workers' comp billing, self-pay, or a pending approval, which changes the intake and booking workflow before the patient arrives. |
| How is your current level of daily function affected by this injury? | Severity of daily function loss is directly weighted in the score, so a severely limiting injury is prioritized well above a mild one regardless of other answers. |
| When did this work injury occur? | How recently the injury occurred helps staff distinguish a fresh occupational injury from a long-standing one that may already have a treatment history elsewhere. |
| Have you already started physical therapy for this injury? | Knowing whether the patient already started physical therapy elsewhere flags potential continuity-of-care questions before a new evaluation is scheduled. |
How Cliont scores work injury rehabilitation leads
Every answer is weighted automatically — no manual review required.
Value signals
- This Injury Sustained At: yes
- Have Physician Referral Or: yes
- Moderately limits daily activities
- Mildly limits daily activities
Urgency signals
- Severely limits daily activities
See the lead your team receives
Work Injury Rehabilitation 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 work injury rehabilitation workflows
| Cliont capability | Work Injury Rehabilitation application |
|---|---|
| Conditional branching | The workers' comp claim question routes to different follow-up context depending on whether the claim is open, pending, self-pay, or unclear, so staff see the right billing path immediately. |
| Weighted scoring | Job-related injury status, physician referral, and daily function severity are the highest-weighted fields, so a referred, on-the-job injury with severe limitation scores well above a mild, non-work case. |
| CRM routing | Qualified work injury leads with claim status and referral details attached are sent straight to your CRM so front desk staff aren't chasing down claim paperwork after booking. |
| Duplicate care detection | The question about whether the patient already started physical therapy elsewhere helps your team flag potential continuity-of-care conversations before the appointment is confirmed. |
Common work injury rehabilitation lead scenarios
Open claim, severe limitation
Patient confirms the injury happened on the job, has a physician referral, and reports the injury severely limits daily activities, an open workers' comp claim plus a referral pushes this straight to the top of the queue.
Work injury, no referral yet
The injury is job-related but the patient hasn't obtained a physician referral or prescription, the intake still captures claim status and severity so your team can follow up on the referral before booking.
Self-pay, mild symptoms
Patient is paying independently rather than through a workers' comp claim and reports only mild limitation, this combination signals lower priority than an open-claim case with severe limitation.
Claim pending, already in PT elsewhere
Claim is under review and the patient has already started physical therapy for the same injury, the intake surfaces this so staff can confirm whether a transfer of care or a second opinion is actually needed.
Injury from months ago
The work injury occurred more than six months ago rather than in the past week, letting staff triage this differently than a fresh, recently reported injury with an active claim.
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 physical therapy intake templates
Work Injury Rehabilitation lead-intake FAQs
How does the intake separate work injuries from other injury types?
The first question asks directly whether the injury was sustained at work or on the job, and this answer carries meaningful weight in the score, so non-occupational injuries are flagged differently from the start.
Does the intake check for a physician referral before booking?
Yes, patients are asked whether they have a physician referral or prescription for physical therapy, which many payers and workers' comp carriers require before treatment begins.
How does workers' compensation claim status affect the lead?
The intake asks whether treatment is under an open claim, a claim pending review, self-pay, or unclear, so your front desk knows the billing path before the patient ever calls.
What if a patient already started physical therapy for this injury?
The intake asks whether treatment has already begun, giving your staff the context to confirm continuity of care rather than duplicating an evaluation.
How is injury severity scored?
Patients select how the injury currently limits daily function, from severe to little to no limitation, and this directly drives the lead's priority score.
Does the timing of the injury matter for scoring?
The intake records whether the injury occurred within the past week, past month, one to six months ago, or longer, so recent injuries can be distinguished from older, more stable cases.
Turn work injury rehabilitation visitors into qualified patients
Give every work injury rehabilitation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.