Turn minor injury enquiries into appointment-ready leads
Patients specify the injury type, confirm whether bleeding is controlled, and note when the injury happened and whether they can put weight on it, with a photo upload attached before anything reaches your CRM.
Preview your minor injury intake
Explore 5 questions from the Minor Injury template. This interactive preview uses illustrative scoring and sample attachments. Open the full survey to try the complete intake.
What a qualified minor injury lead should tell you
Intake for injuries such as cuts, sprains, minor burns, bruises, or suspected fractures where the patient can describe the injury type, bleeding status, timing, and mobility before a visit is scheduled.
- Injury Seeking Care
- Any Bleeding From Injury
- Did Injury Occur
- Move Or Put Weight
- Patient Adult Or Minor
The questions your team needs answered
Every minor injury intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What type of injury are you seeking care for? | The injury-type selection determines which follow-up context (fracture vs. laceration vs. burn) staff see first when reviewing the lead. |
| Has any bleeding from the injury stopped or is it controlled with pressure? | This answer carries the highest weight in the catalog, so a controlled-bleeding case scores notably higher than one where bleeding is still active. |
| When did the injury occur? | Same-day injuries are weighted well above injuries from a week or more ago, letting staff prioritize the freshest cases first. |
| Can you currently move or put weight on the injured area? | Mobility and weight-bearing status gives staff a functional read on severity before they decide how quickly to schedule the visit. |
| Is the patient an adult or a minor child? | Flagging a minor child up front lets staff prepare for guardian consent or pediatric-specific scheduling before the appointment is booked. |
How Cliont scores minor injury leads
Configured answer weights help your team prioritize follow-up. Your team reviews each submission and decides the next step.
Value signals
- Any Bleeding From Injury: yes
- Today
- 1-2 days ago
- 3-7 days ago
- More than a week ago
See an example lead handoff
Illustrative lead details and score show how a submission can reach your team.
Minor Injury 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 minor injury workflows
| Cliont capability | Minor Injury application |
|---|---|
| Weighted scoring engine | Uses the bleeding-control answer and the time-since-injury option to push same-day, controlled-bleeding cases higher in your review queue than older or unclear reports. |
| Conditional question logic | Surfaces the weight-bearing and mobility question alongside the injury-type answer so staff see functional status without the patient re-explaining the injury by phone. |
| Structured lead record | Stores the adult-or-minor-child answer as a distinct field on every record so front-desk staff can flag pediatric cases before the appointment is confirmed. |
| Photo upload capture | Attaches an image of the injury to the same record as the bleeding and timing answers, giving staff visual context before they call the patient back. |
Example minor injury lead scenarios
Illustrative situations explain the intake questions and possible follow-up.
Fresh cut, bleeding controlled
A laceration from earlier today with bleeding already stopped or controlled by pressure scores high for value and moves straight to scheduling review.
Sprain from several days ago
An adult reporting a strain from 3-7 days back with reduced mobility on the area is scored lower on recency but still flagged for a same-service visit.
Minor child, possible fracture
When the patient is a minor and the injury type is marked as a possible fracture, the intake captures weight-bearing status so staff can review before confirming a slot.
Minor burn, old injury
A burn reported as more than a week old is deprioritized on timing but the injury-type and mobility answers still route it as a standard follow-up lead.
Connect Cliont to your workflow
Connect your CRM
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Notify your team
Email, SMS, Slack
Configure other destinations
Google Sheets, configured webhooks, Zapier and API workflows
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
Minor Injury lead-intake FAQs
How does this intake differ from your Cuts and Burns or Sprains and Strains pages?
Minor Injury covers the same core catalog fields but is the general-purpose entry point when the patient isn't sure which category fits or the injury spans more than one type, such as a fall causing both a cut and a sprain.
Does the intake decide if a patient needs the ER instead of urgent care?
No. The form captures the patient's own description of bleeding control, timing, and weight-bearing ability so your staff can make that judgment quickly, but it does not make a clinical determination itself.
Why does the form ask when the injury occurred?
Time since injury carries scoring weight, with same-day injuries weighted higher than injuries from a week or more ago, helping your front desk see which requests are time-sensitive at a glance.
What happens if a patient says bleeding is not controlled?
That answer carries the lowest weight in the catalog for that field, which lowers the lead's overall score so it stands out for a faster callback rather than sitting in a general queue.
Can the intake tell if the patient is a child?
Yes, the adult-or-minor-child question is captured on every submission so staff know before the appointment whether pediatric protocols or a guardian's presence need to be arranged.
Do all injury types go through the same questions?
Yes, every option in the injury-type list, from cuts to possible fractures, runs through the same bleeding, timing, and mobility questions so no injury category skips a qualifying step.
Turn minor injury visitors into qualified patients
Give every minor injury visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.