Bariatric surgery consultation intake that asks what your team needs
Ask upfront whether a patient has tried medically supervised weight loss, whether a doctor has already discussed surgery, and which procedure they're interested in, then collect insurance card photos so your team only books consultations with patients who are actually ready.
The exact intake your bariatric surgery consultation leads complete
This is the real 6-question guided intake for Bariatric Surgery Consultation — the same flow your customers finish before you ever pick up the phone.
What a qualified bariatric surgery consultation lead should tell you
A consultation intake used to evaluate whether a patient has met the medical, behavioral, and insurance prerequisites for bariatric surgery before a surgeon's appointment slot is booked.
- Previously Tried Medically Supervised
- Doctor Ever Discussed Bariatric
- Best Describes Current Stage
- Bariatric Procedure Most Interested
- Patient, Or Inquiring On
- Have Health Insurance Plan
The questions your team needs answered
Every bariatric surgery consultation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Have you previously tried medically supervised weight loss programs? | A prior medically supervised weight loss attempt is often a documented prerequisite insurers and surgeons look for, making a yes answer a strong readiness signal. |
| Has a doctor ever discussed bariatric surgery as an option for you? | If a doctor has already raised bariatric surgery as an option, the patient typically needs less baseline education and can move faster toward a specialist consult. |
| Which best describes your current stage in considering bariatric surgery? | The stage answer tells staff whether to send educational content to an early researcher or fast-track scheduling for someone already referred or insurance-approved. |
| Which type of bariatric procedure are you most interested in? | Knowing which procedure a patient is leaning toward lets the practice match them to the right surgeon or prepare procedure-specific consult materials in advance. |
| Are you the patient, or are you inquiring on behalf of someone else? | Distinguishing a patient from a caregiver filling out the form prevents booking a slot based on secondhand answers before the actual patient's eligibility is confirmed. |
| Do you have health insurance you plan to use for this consultation? | Insurance status determines whether the next step should be a financial/self-pay discussion or a straightforward scheduling path. |
How Cliont scores bariatric surgery consultation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Previously Tried Medically Supervised: yes
- Doctor Ever Discussed Bariatric: yes
Disqualifiers
- Not sure yet
See the lead your team receives
Bariatric Surgery Consultation 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 bariatric surgery consultation workflows
| Cliont capability | Bariatric Surgery Consultation application |
|---|---|
| Conditional routing | Separates 'I am the patient' responses from 'Caregiver or family member' responses so caregiver inquiries can be flagged for additional confirmation before a slot is held. |
| Weighted lead scoring | Weighs prior medically supervised weight loss attempts and prior physician discussion of surgery more heavily, since both are strong indicators of surgical readiness. |
| Insurance-aware qualification | Uses the insurance question to separate self-pay inquiries, which need a financial conversation, from insured patients who can move toward scheduling. |
| Stage-based segmentation | Sorts leads by stage (researching, referred, ready to consult, awaiting insurance approval) so front-desk staff can prioritize outreach differently for each group. |
| Procedure-preference capture | Records which procedure a patient is interested in, or if they're undecided, so consultations can be pre-matched to the right specialist when possible. |
Common bariatric surgery consultation lead scenarios
Physician-referred, insurance pending
Patient was referred by their doctor and marks 'Awaiting insurance approval' as their stage, with both high-value signals triggered. Intake flags this as a strong lead but routes it to a pre-authorization queue rather than immediate scheduling.
Early-stage researcher
Patient selects 'Just researching options,' hasn't tried a supervised program, and no doctor has discussed surgery with them. Neither high-value signal fires, so the lead scores lower and is directed toward educational follow-up instead of a consult slot.
Caregiver inquiring for someone else
The person completing the form selects 'Caregiver or family member' rather than 'I am the patient.' Intake handles this differently, since the actual patient's answers and consent will need to be confirmed before any appointment is confirmed.
Ready to consult, procedure undecided
Patient has already tried a medically supervised program and is 'Ready to consult a specialist,' but selects 'Not sure yet' for procedure type. This lead is qualified but needs a broader consult rather than a procedure-specific one.
Self-pay inquiry without insurance
Patient answers no to having insurance for the consultation. Even with strong readiness signals elsewhere, this changes the next step to a financial/self-pay conversation before scheduling.
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 weight management intake templates
Bariatric Surgery Consultation lead-intake FAQs
How does the intake tell the difference between someone just researching and someone ready to book?
The stage question separates 'just researching' and 'referred by my doctor' or 'ready to consult a specialist' into distinct answers, so leads in early research get routed differently than those already primed for a consultation.
Can this intake handle a family member filling it out instead of the patient?
Yes. The intake asks directly whether the person answering is the patient or a caregiver, so staff know whose eligibility and consent actually need to be confirmed before booking.
Does the intake capture insurance status before a consultation is scheduled?
Yes, patients are asked whether they have insurance they plan to use, which lets your team flag self-pay inquiries for a financial conversation instead of a standard scheduling flow.
How is procedure interest used if a patient isn't sure which surgery they want?
The procedure question allows a 'Not sure yet' response, so those leads are still qualified but marked for a general consultation rather than being pre-matched to a bypass- or sleeve-specific slot.
What happens to a lead who hasn't tried a supervised weight loss program or discussed surgery with a doctor?
Both of those questions are the highest-weighted signals in this intake, so a lead answering no to each scores lower and is treated as lower priority rather than being automatically booked.
Does this connect with intake for related services like Medical Weight Management or Metabolic Health Evaluation?
Bariatric Surgery Consultation is its own scored intake in the Weight Management library alongside siblings like Medical Weight Management and Metabolic Health Evaluation, so patients can be routed to the right intake based on what they're actually asking for.
Turn bariatric surgery consultation visitors into qualified patients
Give every bariatric surgery consultation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.