Every preoperative clearance request, scored before it reaches your
Patients tell you when surgery is scheduled, what type of procedure it is, and whether they have chronic conditions like heart or lung issues, plus upload their clearance form and recent labs or EKG before you ever open the chart.
The exact intake your preoperative clearance leads complete
This is the real 6-question guided intake for Preoperative Clearance — the same flow your customers finish before you ever pick up the phone.
What a qualified preoperative clearance lead should tell you
A primary care visit that evaluates a patient's medical readiness for an upcoming surgical procedure, based on surgery timing, existing chronic conditions, and available test results.
- Surgery Scheduled
- Surgery Having
- Surgeon'S Office Given Specific
- Have Any Ongoing Chronic
- Established As Patient With
- Have Recent Test Results,
The questions your team needs answered
Every preoperative clearance intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| When is your surgery scheduled? | Surgery timing carries the steepest weighting in the catalog, so a patient operating within a week gets prioritized far above one who hasn't scheduled yet. |
| What type of surgery are you having? | The free-text procedure description helps staff gauge case complexity before assigning visit length, even though it isn't scored. |
| Has the surgeon's office given you a specific clearance form to complete? | Knowing whether the surgeon's office already issued a specific clearance form determines whether the visit can use a standard template or needs custom paperwork. |
| Do you have any ongoing chronic conditions, such as heart, lung, or diabetes issues? | Flagging ongoing chronic conditions like heart or lung issues tells the provider the visit may need more clinical review time. |
| Are you currently established as a patient with a primary care provider? | Whether the patient is already established with a PCP is directly weighted, since it affects whether a new-patient workup needs to happen alongside clearance. |
| Do you have recent test results, such as labs or an EKG, available to share? | Having recent labs or an EKG already available lets the provider review results ahead of the visit instead of ordering new tests on the spot. |
How Cliont scores preoperative clearance leads
Every answer is weighted automatically — no manual review required.
Value signals
- Within 1 week
- 1 to 4 weeks
- 1 to 3 months
- Not yet scheduled
- Established As Patient With: yes
See the lead your team receives
Preoperative Clearance 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 preoperative clearance workflows
| Cliont capability | Preoperative Clearance application |
|---|---|
| Weighted lead scoring | Ranks preoperative clearance requests by how soon surgery is scheduled, so a patient having surgery within a week doesn't sit behind one whose date isn't set yet. |
| Document upload capture | Collects the surgeon's clearance form and any recent labs or EKG results directly in the intake, so front desk staff aren't chasing paperwork after the appointment is booked. |
| Established-patient flagging | Surfaces whether the patient already has a primary care relationship, helping staff decide if new-patient forms need to accompany the clearance visit. |
| Free-text procedure capture | Lets patients describe their surgery in their own words instead of forcing a rigid category list that may not match what their surgeon's office told them. |
Common preoperative clearance lead scenarios
Surgery next week, established patient
The intake flags the tight surgery date so the clearance visit gets booked ahead of lower-urgency requests, and confirms the patient already has a PCP relationship on file.
New patient, surgery a month out
The patient isn't yet established with the practice, so the intake surfaces that gap alongside the surgery timeline, letting staff decide whether to combine new-patient onboarding with the clearance visit.
Chronic conditions, no clearance form
The patient reports ongoing heart or diabetes issues but hasn't received a clearance form from the surgeon's office yet, signaling the visit will need more time and possibly a follow-up call before scheduling.
Surgery date unset, labs in hand
Surgery hasn't been scheduled yet, but the patient already has recent labs or an EKG ready to share, so the front desk can prep the chart even before a firm appointment slot exists.
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 primary care intake templates
Preoperative Clearance lead-intake FAQs
How does the intake prioritize patients by surgery date?
Surgery timing is a single-choice field with the highest weight given to patients having surgery within 1 week, tapering down through 1-4 weeks, 1-3 months, and not yet scheduled, so your team sees which requests need a visit booked first.
What if the patient hasn't received a clearance form from their surgeon yet?
The intake asks directly whether the surgeon's office has issued a specific clearance form, so you know upfront whether the visit can follow a standard template or needs to wait on outside paperwork.
Can patients upload lab results or an EKG before the appointment?
Yes, the intake asks whether recent labs or an EKG are available and collects them as an upload, so your team can review results before the patient arrives instead of during the visit.
Does the intake distinguish new patients from established ones?
It asks whether the patient is already established with a primary care provider, which carries its own weight, helping you tell whether a clearance visit doubles as a new-patient intake.
How are chronic conditions like heart or lung disease captured?
A yes/no question asks about ongoing chronic conditions such as heart, lung, or diabetes issues, giving your team a heads-up on cases that may need more clinical review time before signing off.
The surgery type field is free text — how does that get used?
Patients describe their upcoming procedure in their own words, which your staff can scan quickly to gauge complexity before the visit rather than relying on a fixed dropdown that might not match their surgeon's terminology.
Turn preoperative clearance visitors into qualified patients
Give every preoperative clearance visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.