Know which preventive care leads are worth appointment time
Patients tell you upfront whether they want an annual wellness checkup, a specific screening, or a vaccination, whether they already have an established primary care provider, and when they'd like to be seen — then upload their insurance card and photo ID before you ever see the request.
The exact intake your preventive care leads complete
This is the real 6-question guided intake for Preventive Care — the same flow your customers finish before you ever pick up the phone.
What a qualified preventive care lead should tell you
Routine wellness visits, screenings, immunizations, and result follow-ups that don't involve a new symptom complaint, distinguished from sick visits by intent and from annual physicals by covering a broader set of visit types.
- Best Describes What
- This Preventive Care Visit
- Without Established Primary Care
- Noticed Any New Symptoms
- Would Like This Visit
- Have Insurance Or Program
The questions your team needs answered
Every preventive care intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What best describes what you are looking for? | The visit type tells staff which slot length and resources to prepare, since a screening, vaccination, or follow-up each require different setup than a standard wellness checkup. |
| Who is this preventive care visit for? | Knowing whether the visit is for the patient, a child, or another adult determines who the actual record belongs to and who the front desk should contact to confirm details. |
| Are you currently without an established primary care provider? | Patients without an established provider represent a new-patient opportunity worth routing differently than an existing patient scheduling a routine recheck. |
| Have you noticed any new symptoms you want discussed at this visit? | A yes here doesn't change the preventive-care score but flags that staff may need to review whether the visit should shift toward a sick visit instead. |
| When would you like this visit to take place? | Preferred timing lets scheduling staff prioritize among wellness-visit leads without treating every request as equally time-sensitive. |
| Do you have insurance or a program you plan to use for this visit? | Insurance status determines whether the front desk needs to verify coverage or raise self-pay options before the visit is confirmed. |
How Cliont scores preventive care leads
Every answer is weighted automatically — no manual review required.
Value signals
- Annual wellness checkup
- Specific screening or lab test
- Vaccination or immunization
- Follow-up on previous results
- Without Established Primary Care: yes
- As soon as possible
Disqualifiers
- Not sure yet
See the lead your team receives
Preventive Care 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 preventive care workflows
| Cliont capability | Preventive Care application |
|---|---|
| Conditional flagging | A yes answer on new symptoms surfaces separately from the preventive visit-type score, so staff can spot a visit that may need to shift toward a sick visit before it's confirmed. |
| Document upload | Insurance card and photo ID collection happens during intake so front-desk staff aren't chasing that information after a wellness checkup or screening is already on the calendar. |
| Lead scoring engine | Annual wellness checkups, screenings, vaccinations, and follow-ups are weighted higher than an undecided request, while patients without an established provider are scored as high-value new-patient leads. |
| Proxy and dependent intake | The who-is-this-for question lets the CRM record distinguish a self-booking from a parent scheduling for a child or another adult, without needing a separate form. |
| CRM routing | Qualified preventive visits arrive in your CRM with visit type and preferred timing attached, so scheduling staff can match each request to the right appointment length. |
Common preventive care lead scenarios
New patient without a PCP
The patient reports no established primary care provider and wants an annual wellness checkup as soon as possible, so the intake flags them as a new-patient opportunity worth a fuller first slot.
Routine vaccination for existing patient
An established patient just needs a vaccination and is flexible on timing, so the intake routes it as a quick, low-friction booking rather than treating it like an open-ended new-patient visit.
Follow-up flagged with new symptoms
A patient scheduling a follow-up on previous results also reports new symptoms, which staff can see before confirming the slot even though the visit stays logged as preventive care.
Screening booked for a parent
The requester is scheduling a specific screening for another adult they care for, so the CRM entry captures who the caregiver is separately from who the visit is actually for.
Uncertain patient exploring options
The patient selects 'not sure yet' for visit type and has no insurance to use, so the lead is still captured but flagged for staff to clarify the right visit type 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 primary care intake templates
Preventive Care lead-intake FAQs
How does the intake identify patients who need a new primary care provider?
The intake asks directly whether the patient currently lacks an established provider, and a yes answer is treated as a higher-value signal since it often means a longer first visit and ongoing relationship rather than a one-off appointment.
What happens when a patient flags new symptoms on a preventive visit?
The intake records the new-symptoms answer separately from the visit-type score so staff can see it before confirming the slot, since a visit that starts as preventive may need to be reclassified or given more time.
Can patients book a preventive visit for a child or another adult?
Yes, the intake asks whether the visit is for the patient themselves, their child, or another adult they care for, so the CRM record reflects who the actual patient is regardless of who filled out the form.
Does the intake collect insurance information before the visit is confirmed?
Patients are asked whether they have insurance or a program they plan to use, and the intake collects an insurance card and photo ID upload so front-desk staff can verify coverage before the appointment is booked.
How are different visit types like screenings and vaccinations scored?
Annual wellness checkups, specific screenings, vaccinations, and result follow-ups all carry higher weight than an undecided 'not sure yet' answer, so the more defined the request, the more clearly it's prioritized in your queue.
How is this different from the Annual Physical intake?
The Preventive Care intake covers a wider range of visit types, including screenings, vaccinations, and follow-ups on prior results, while the Annual Physical intake is scoped specifically to the yearly wellness exam.
Turn preventive care visitors into qualified patients
Give every preventive care visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.