Depression intake that captures symptom duration and daily impact up
Ask about symptom duration, daily functioning impact, and preferred session format before you hold an intake slot — Cliont routes qualified clients straight to your CRM.
The exact intake your depression support leads complete
This is the real 5-question guided intake for Depression Support — the same flow your customers finish before you ever pick up the phone.
What a qualified depression support lead should tell you
One-on-one talk therapy intake for a client experiencing ongoing low mood or loss of interest, capturing how long symptoms have lasted and whether they're interfering with daily functioning so a therapist can gauge fit and priority before booking.
- This Therapy Support
- Long Has This Low
- This First Time Seeking
- This Affected Daily Activities
- Preferred Session Format
The questions your team needs answered
Every depression support intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Who is this therapy support for? | Knowing whether the client themselves, a child, a partner, or another family member is the actual subject changes how you structure consent and the first session. |
| How long has this low mood or loss of interest been present? | Symptoms lasting 2 weeks to 1 year score highest because that window most reliably indicates a depressive episode warranting therapy, versus a very recent dip that may resolve on its own. |
| Is this the first time seeking therapy for this concern, or a return to it? | Whether someone is new to therapy, returning, or currently working with another provider affects whether you're starting fresh or coordinating care. |
| Has this affected daily activities such as work, school, or relationships? | A 'yes' on functional impact carries more weight than 'no,' since disruption to work, school, or relationships signals a more pressing need for an intake slot. |
| What is your preferred session format? | Capturing the preferred session format up front lets you match the client to the right scheduling option without a back-and-forth after the score is delivered. |
How Cliont scores depression support leads
Every answer is weighted automatically — no manual review required.
Value signals
- Less than 2 weeks
- 2 weeks to 3 months
- 3 months to 1 year
- More than 1 year
- This Affected Daily Activities: yes
See the lead your team receives
Depression Support 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 depression support workflows
| Cliont capability | Depression Support application |
|---|---|
| Weighted scoring engine | Combines the symptom-duration answer with the daily-impact yes/no response to prioritize clients whose depression is both sustained and functionally disruptive. |
| Conditional branching | Routes leads differently based on whether the intake is for the client themselves, a child, a partner, or another family member. |
| CRM delivery | Sends scored depression-support leads directly to your CRM with duration, impact, and therapy-history answers attached, instead of leaving them in an inbox. |
| Structured preference capture | Records the client's session-format preference (in-person, video, phone, no preference) so scheduling can match the delivery method they actually want. |
Common depression support lead scenarios
New client, weeks-long low mood
Symptoms in the 2-week to 3-month range paired with a 'yes' on daily impact score as high value, flagging the lead for a prompt intake slot.
Long-standing depression affecting daily life
A client reporting more than a year of low mood who also confirms it's disrupting work or relationships is prioritized differently from someone with the same duration but no reported impact.
Parent inquiring on behalf of a child
When the intake answer identifies the concern as being for 'My child' rather than the person filling out the form, the therapist can route it toward guardian consent steps before scheduling.
Returning after a previous course of therapy
A client marking 'Returning to therapy' carries different context than a first-time client, letting the therapist tailor the intake conversation around prior treatment history.
Currently in therapy elsewhere
Someone who indicates they're already working with another provider may need a referral conversation instead of a session slot, which the intake surfaces before it's booked.
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 individual therapy intake templates
Depression Support lead-intake FAQs
How does the intake handle someone filling it out for a family member instead of themselves?
The 'who is this for' question separates self, child, partner, or other family member responses so you can see immediately whether you're triaging the actual client or an intermediary before booking an intake session.
Why does a 2-week to 3-month duration score similarly to a year-long history?
Both the 2 weeks-to-3-months and 3 months-to-1-year duration options carry the highest weights, since sustained depressive symptoms in that range typically indicate a clear, appropriate need for therapy rather than a transient dip.
What happens if a client says depression hasn't affected their daily activities?
A 'no' answer on the daily impact question still carries weight and is routed to your CRM, but it scores lower than a 'yes,' helping you distinguish clients who may benefit from a lighter-touch intake conversation.
Does the intake screen for safety or crisis risk?
No — the current catalog for this subservice covers duration, daily impact, therapy history, and session format only, so it should not be relied on as a clinical risk screen; any crisis indicators would need to surface through your own intake conversation.
How is a client currently in therapy elsewhere treated differently from a first-time client?
The therapy-history question distinguishes first-time, returning, and currently-in-therapy-elsewhere responses, which lets you flag potential referral or coordination-of-care situations before you commit a session slot.
Can I see a client's session format preference before I schedule?
Yes — the intake captures whether they prefer in-person, video, phone, or have no preference, so that detail arrives in your CRM alongside the qualification score, ready for scheduling.
Turn depression support visitors into qualified patients
Give every depression support visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.