Fever and flu intake that captures temperature and hydration status up
Patients answer questions about fever severity, symptom duration, and chronic conditions before they ever reach your front desk, so your team can see who needs same-day care versus a lower-acuity visit.
The exact intake your fever and flu symptoms leads complete
This is the real 6-question guided intake for Fever and Flu Symptoms — the same flow your customers finish before you ever pick up the phone.
What a qualified fever and flu symptoms lead should tell you
Assessment of patients presenting with fever, chills, body aches, or flu-like symptoms, where fever severity, symptom duration, and hydration status determine how quickly the patient needs to be seen.
- Patient Needing Care
- High Has Fever Been,
- Long Have Symptoms Lasted
- Additional Symptoms Present
- Patient Have Any Chronic
- Patient Able Keep Fluids
The questions your team needs answered
Every fever and flu symptoms intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Who is the patient needing care? | Identifying whether the patient is the caller, their child, or another adult changes how urgently the case should be reviewed and who staff need to call back. |
| How high has the fever been, if measured? | The measured fever range is weighted so that higher readings score above unmeasured or low-grade fevers, helping staff separate mild cases from ones needing faster attention. |
| How long have the symptoms lasted? | Duration distinguishes a fresh 24-hour onset from an illness that has lingered over a week, which can point to different underlying causes. |
| Which additional symptoms are present? | Difficulty breathing carries a notably lower weight than cough or body aches, flagging it as a symptom combination that may need a higher level of care than a routine fever visit. |
| Does the patient have any chronic health conditions? | An existing chronic condition is weighted higher than having none, since it can change how a fever or flu illness should be managed. |
| Is the patient able to keep fluids down? | Inability to keep fluids down is scored far lower than being able to, surfacing dehydration risk as a distinct concern from the fever reading itself. |
How Cliont scores fever and flu symptoms leads
Every answer is weighted automatically — no manual review required.
Value signals
- No fever or not measured
- Under 101°F (38.3°C)
- 101-103°F (38.3-39.4°C)
- Above 103°F (39.4°C)
- Cough or congestion
- Body aches or headache
Urgency signals
- Patient Able Keep Fluids
See the lead your team receives
Fever and Flu Symptoms 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 fever and flu symptoms workflows
| Cliont capability | Fever And Flu Symptoms application |
|---|---|
| Weighted scoring engine | Combines the fever severity answer with the fluid-intake answer so a high fever paired with an inability to keep fluids down scores differently than a high fever alone. |
| Multi-select symptom capture | Records every selected symptom from the additional symptoms question — including difficulty breathing — as a distinct data point rather than collapsing them into a single free-text field. |
| Patient relationship tagging | Uses the 'who is the patient' answer to tag each lead as self, child, or another adult, so front-desk staff can immediately see if a case involves a pediatric patient. |
| CRM handoff | Sends the completed fever and flu answer set, including duration and chronic condition status, into your CRM so staff aren't re-asking triage questions on the phone. |
Common fever and flu symptoms lead scenarios
High fever with dehydration risk
A parent reports a child's fever above 103°F combined with an inability to keep fluids down, which the intake flags as a higher-concern combination that shouldn't wait behind routine bookings.
Chronic condition complicates recovery
An adult caring for another adult reports symptoms lasting over a week alongside an existing chronic health condition, prompting the intake to surface both factors for staff review before scheduling.
Short, mild self-care case
A patient reports a fever under 101°F for less than 24 hours with no other symptoms, which the intake captures as a lower-severity presentation compared to prolonged or multi-symptom cases.
Prolonged flu-like illness
Symptoms lasting more than a week with both cough and body aches present a different picture than a fresh 24-hour onset, and the intake records duration and symptom combination separately so staff can triage accordingly.
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
Fever and Flu Symptoms lead-intake FAQs
How does the intake handle a patient who can't keep fluids down?
The fluid intake question captures this directly, and a 'no' answer is weighted to stand out from a 'yes' answer, helping staff spot dehydration risk before a slot is confirmed.
Can the intake tell whether the patient is a child or an adult?
Yes, the first question asks who needs care — the patient themselves, their child, or another adult they're responsible for — so the record clearly identifies the patient relationship before any clinical details are reviewed.
What happens if a patient selects difficulty breathing as a symptom?
Difficulty breathing is captured in the additional symptoms question and is weighted differently from cough, body aches, or GI symptoms, which helps flag cases that may need a level of care beyond a standard fever and flu visit.
How are chronic health conditions factored into the lead?
The chronic conditions question is a direct yes/no, and a 'yes' carries more weight than a 'no,' since existing conditions can change how quickly a fever or flu presentation needs to be evaluated.
Does the intake distinguish a new fever from one that's dragged on for a week?
Symptom duration is asked as its own question with four distinct ranges, so a same-day onset and a week-plus illness are recorded differently even if the fever reading is identical.
Is this the right intake for respiratory-heavy complaints, or should I use a different one?
This intake is built around fever and flu-type presentations; if cough or breathing issues are the primary complaint rather than fever, the Respiratory Symptoms intake in this library is the closer fit.
Turn fever and flu symptoms visitors into qualified patients
Give every fever and flu symptoms visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.