Every contraception consultation enquiry, scored before it reaches
Patients share their main goal, confirm they're not currently pregnant, and flag whether they can come in for an exam — all before your team requests ID and insurance, so only appointment-ready leads reach your CRM.
The exact intake your contraception consultation leads complete
This is the real 6-question guided intake for Contraception Consultation — the same flow your customers finish before you ever pick up the phone.
What a qualified contraception consultation lead should tell you
A consultation to start, switch, or stop a birth control method, where intake needs to establish the patient's goal, current method, pregnancy status, and whether an in-person exam is required before a clinician can recommend an option.
- Best Describes What Help
- Using Any Form Contraception
- Main Goal This Consultation
- Confirm That Not Pregnant
- Soon Would Like Start
- Able Attend In-Person Visit
The questions your team needs answered
Every contraception consultation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What best describes what you need help with today? | This determines whether the patient needs a new-start work-up, a switch consult, a discontinuation visit, or just information, which changes what the visit needs to cover. |
| Are you currently using any form of contraception? | Knowing whether the patient is already on a method surfaces switch-related context, like side effects or method failure, that a first-time start wouldn't involve. |
| What is your main goal for this consultation? | The stated goal carries the heaviest weight in scoring and separates pregnancy prevention from symptom management, which can call for different clinical conversations. |
| Can you confirm that you are not currently pregnant? | A 'no' or uncertain answer should hold the lead out of automatic contraception booking until pregnancy status is clarified, since starting most methods isn't appropriate otherwise. |
| How soon would you like to start or change your contraception method? | Selecting 'Immediately' marks the request as time-sensitive so it can be prioritized ahead of patients who are still exploring options. |
| Are you able to attend an in-person visit if a physical exam is needed? | Patients who can't attend an in-person exam may need to be limited to methods that don't require a fitting or insertion, which affects which appointment type gets offered. |
How Cliont scores contraception consultation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Preventing pregnancy
- Regulating menstrual cycle
- Managing symptoms like acne or cramps
- Other personal reason
- Confirm That Not Pregnant: yes
- Able Attend In-Person Visit: yes
Urgency signals
- Immediately
See the lead your team receives
Contraception 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 contraception consultation workflows
| Cliont capability | Contraception Consultation application |
|---|---|
| Conditional branching | The intake path changes based on whether the patient is starting, switching, stopping, or asking for general information, so downstream questions stay relevant to that intent. |
| Lead scoring | Consultation goal, pregnancy confirmation, and exam availability feed into the score, so a patient ready for an in-person visit with a clear goal ranks above someone just exploring options. |
| Pre-booking holds | A patient who can't confirm she isn't pregnant can be routed for follow-up instead of automatically filling an appointment slot meant for contraception counseling. |
| CRM routing | Qualified appointments arrive in your CRM already tagged with goal, timing, and exam-readiness, so front-desk staff know which visit type to schedule. |
Common contraception consultation lead scenarios
Immediate switch, ready to book
Patient wants to change methods right away, confirms she isn't pregnant, and can attend in person — the intake flags this as time-sensitive and appointment-ready.
Just exploring options
No urgency selected and the request is for general information only, so the lead can be queued for a lower-touch response instead of a full booking slot.
Pregnancy status unconfirmed
The patient can't confirm she isn't pregnant, which should hold the lead before it fills a contraception slot until that's clarified.
Can't attend in person
Patient wants to start or continue a method but says she can't come in for a physical exam, pointing toward exam-free method options rather than a standard visit.
Symptom-driven request
Goal is managing acne or cramps rather than pregnancy prevention, which still scores well but may route to a different clinical conversation than a prevention-focused visit.
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 women's health intake templates
Contraception Consultation lead-intake FAQs
What happens if a patient can't confirm she isn't pregnant?
That answer is captured directly from the intake and can be used to hold the lead out of automatic booking into a contraception slot until pregnancy status is clarified, rather than letting it fill an appointment that may need to change.
Does the intake tell us if someone needs a new-start visit versus a switch or stop?
Yes — the first question captures whether the patient is starting, switching, stopping, or just asking for information, so your team can see the visit type before the appointment is booked.
How does the form handle patients who say they can't come in for an exam?
That response is recorded separately so staff can see which leads may need exam-free method options or a different visit format instead of a standard in-person slot.
Can this intake flag urgent requests?
Patients who say they want to start or switch immediately are distinguished from those who are just exploring, so time-sensitive leads can be surfaced ahead of lower-urgency ones.
Will this work alongside our menstrual concerns or annual visit intake?
Each subservice has its own intake, so a patient asking about cycle regulation through contraception is captured here, while a broader menstrual-concerns visit routes through that separate form.
What does the intake ask about current contraception use?
It asks whether the patient is currently using a method, which helps your team understand if this is a fresh start or a switch that may involve stopping something already in use.
Turn contraception consultation visitors into qualified patients
Give every contraception consultation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.