See who prescribed it before you book an ineligible slot
Patients confirm which medication needs follow-up, why now, and who originally prescribed it, plus whether they're in the prescriber's licensed state — with a medication label photo and ID captured before any slot is booked.
The exact intake your medication follow-up leads complete
This is the real 5-question guided intake for Medication Follow-Up — the same flow your customers finish before you ever pick up the phone.
What a qualified medication follow-up lead should tell you
A virtual check-in on an existing prescription to confirm who originally prescribed it, why the patient needs follow-up now, and whether the visit can legally happen given the prescriber's licensing state.
- Taking Prescribed Medication That
- Main Reason This Follow-Up
- Originally Prescribed This Medication
- Soon Would Like This
- Located In Same State
The questions your team needs answered
Every medication follow-up intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Are you currently taking a prescribed medication that needs follow-up? | Confirms the patient actually has an active prescription needing follow-up rather than a general medication question, which is the baseline qualifier for this intake. |
| What is the main reason for this follow-up? | Segments the lead so you can route, price, and prioritize it correctly. |
| Who originally prescribed this medication? | Tells you whether records already exist with a provider you see, or whether staff need to request history from a previous or outside clinic before the visit. |
| How soon would you like this follow-up appointment? | Separates same-day and this-week requests from flexible ones so urgent follow-ups aren't stuck behind routine refills in the queue. |
| Are you located in the same state where the prescribing provider is licensed? | Flags a state-licensing mismatch before a slot is offered, preventing a booked visit that a provider may not be permitted to conduct. |
How Cliont scores medication follow-up leads
Every answer is weighted automatically — no manual review required.
Value signals
- Taking Prescribed Medication That: yes
- A provider I currently see
- A previous provider, no longer seeing them
- A different clinic or hospital
- Not sure
- Today
See the lead your team receives
Medication Follow-Up 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 medication follow-up workflows
| Cliont capability | Medication Follow-Up application |
|---|---|
| Conditional branching | If a patient answers no to currently taking a prescribed medication, the intake can skip deeper prescriber and timing questions instead of forcing them through the full flow. |
| Automatic flagging | A 'no' on the same-state licensing question is auto-flagged so staff catch potential eligibility issues before a slot is confirmed. |
| Lead scoring by urgency | Today and this-week timing answers push the lead higher in priority than flexible or two-week requests, without any manual triage. |
| CRM field mapping | The prescriber-source answer (current provider, previous provider, different clinic, not sure) is passed to your CRM as a distinct field for care-coordination context. |
Common medication follow-up lead scenarios
Same-day side effect check
Patient flags side effects and wants a same-day slot with the provider they currently see — the intake surfaces this as a high-value, time-sensitive case.
Routine refill, no urgency
Patient just needs a refill and selects flexible timing, so the intake routes it as a normal-priority follow-up rather than treating it like an urgent case.
Prescribed out of state
Patient's medication came from a different clinic and they're not in the same state as the prescriber, triggering a licensing-match flag before scheduling.
Unclear prescriber history
Patient isn't sure who originally prescribed the medication or why follow-up is needed, so the lead is captured but marked for a manual check 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 telemedicine intake templates
Medication Follow-Up lead-intake FAQs
What happens if the patient doesn't know who prescribed their medication?
The intake still records the visit request, but a 'Not sure' answer on the prescriber question is a lower-confidence signal, so the lead is flagged for review rather than auto-approved for scheduling.
Does the intake check whether the patient is even in a state your clinicians can see?
Yes — the intake asks whether the patient is in the same state where the prescribing provider is licensed, so mismatches surface before a slot is offered instead of after.
Can this handle simple refill requests without treating them as urgent?
Yes, the reason-for-follow-up question separates refill requests from side-effect or dose-adjustment cases, and the timing question lets patients indicate they're flexible, so routine refills don't get flagged as time-sensitive.
How does the intake know a follow-up is urgent?
Patients select how soon they want the appointment, from today to no urgency, so same-day and this-week requests can be distinguished from flexible ones without a phone call.
Is this different from the Chronic Care Follow-Up intake?
Yes — Medication Follow-Up is built around a single prescription's status, reason, and prescriber source, while Chronic Care Follow-Up covers ongoing condition management more broadly.
What if the patient was prescribed the medication by a provider they no longer see?
The prescriber-source question captures this as its own option, distinct from a current provider or a different clinic, so your team knows a records request may be needed before adjusting anything.
Turn medication follow-up visitors into qualified patients
Give every medication follow-up visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.