Turn cuts and burns enquiries into appointment-ready leads
Patients describe whether bleeding is controlled, how large the wound or burn is, and whether infection signs are present, plus upload a photo of the injury, so your front desk can triage before an appointment slot is booked.
The exact intake your cuts and burns leads complete
This is the real 6-question guided intake for Cuts and Burns — the same flow your customers finish before you ever pick up the phone.
What a qualified cuts and burns lead should tell you
Urgent evaluation of open wounds, lacerations, and thermal or chemical burns to determine severity, infection risk, and how quickly the patient needs to be seen.
- Injury Seeking Care
- Bleeding Or Wound Uncontrolled
- Large Affected Area
- There Signs Infection Such
- Injury
- Soon Be Seen
The questions your team needs answered
Every cuts and burns intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What type of injury are you seeking care for? | Segments the lead so you can route, price, and prioritize it correctly. |
| Is the bleeding or wound currently uncontrolled despite applying pressure? | Uncontrolled bleeding is the highest-weighted answer in the catalog, so it's the single strongest signal that a lead needs to be seen faster than a standard slot. |
| How large is the affected area? | Every option in this question carries weight, including 'Not sure', so wound or burn size always contributes to the score rather than being treated as optional detail. |
| Are there signs of infection such as increasing redness, swelling, warmth, or pus? | Reported infection signs add weight independent of how the patient describes their own urgency, catching cases patients might otherwise underplay. |
| Who is the injury for? | Knowing whether the injury belongs to the patient, a child, or another adult they care for changes what staff need to confirm before the appointment is booked. |
| How soon are you hoping to be seen? | A patient selecting 'Immediately' is the only answer flagged as urgent, letting staff separate genuine same-day requests from patients comfortable waiting a few days. |
How Cliont scores cuts and burns leads
Every answer is weighted automatically — no manual review required.
Value signals
- Bleeding Or Wound Uncontrolled: yes
- Smaller than a palm
- About the size of a hand to forearm
- Larger than a forearm
- Not sure
- There Signs Infection Such: yes
Urgency signals
- Immediately
See the lead your team receives
Cuts and Burns 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 cuts and burns workflows
| Cliont capability | Cuts And Burns application |
|---|---|
| Weighted scoring | Bleeding control, wound size, and infection signs each carry their own weight, so a large burn with infection signs scores higher than a small, well-controlled cut even before staff read the notes. |
| Branching logic | Selecting 'Both a cut and a burn' can route the patient through the size and infection questions for a combined injury rather than treating it as a single wound type. |
| Photo capture | The intake collects a photo of the injury alongside the size and bleeding answers so staff have visual context before deciding how quickly to bring the patient in. |
| Urgency tagging | Patients who select 'Immediately' for timing are tagged separately from those choosing 'Today' or 'Within a few days', letting front-desk staff prioritize the queue accordingly. |
Common cuts and burns lead scenarios
Uncontrolled bleeding, wants immediate care
Patient reports bleeding that hasn't stopped despite pressure and selects 'Immediately' for timing — the intake flags this combination for urgent handling rather than a routine slot.
Burn larger than a forearm
The affected-area answer lands in the largest size bracket, which carries the highest weight and pushes the lead toward priority review regardless of how the patient describes urgency.
Redness and drainage days later
Patient selects signs of infection but only wants to be seen 'within a few days' — the intake still surfaces the infection flag so staff can decide whether to pull the visit forward.
Parent booking for a child's cut
The 'who is the injury for' answer identifies a child, which changes what staff need to confirm before scheduling versus an adult self-reporting the same wound.
Patient unsure how large the wound is
Selecting 'Not sure' for size still carries a meaningful weight in scoring, so the lead isn't deprioritized just because the patient couldn't estimate it precisely.
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 urgent care intake templates
Cuts and Burns lead-intake FAQs
How does the intake separate a minor cut from one that needs to be seen right away?
The bleeding-control question and the timing question are scored together, so a patient reporting uncontrolled bleeding and wanting to be seen immediately is flagged well above a routine, well-controlled cut.
Can the intake tell if a burn is serious based on size alone?
The affected-area question has weighted options from smaller-than-palm up to larger-than-forearm, and every option in that range contributes to the score, so size alone can still push a lead toward priority review.
What happens if a patient reports signs of infection?
Redness, swelling, warmth, or pus is a dedicated yes/no question with its own weight, so it adds to the lead's score independently of how urgent the patient says they feel.
Does the intake know if the injury is for the patient or their child?
Yes, a separate question asks whether the injury is for the patient, a child, or another adult they care for, which lets staff prepare differently before the appointment is confirmed.
What photo do patients need to submit for a cut or burn?
Patients are asked to upload a clear photo of the injury so staff can visually assess extent and severity alongside the bleeding, size, and infection answers before the visit is scheduled.
How is patient-reported urgency captured if they don't mention bleeding or infection?
The 'how soon are you hoping to be seen' question stands on its own, so a patient who selects 'Immediately' is still surfaced for faster follow-up even if their other answers are lower-severity.
Turn cuts and burns visitors into qualified patients
Give every cuts and burns visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.