Know which self-esteem leads are ready for an intake session
Cliont's guided intake asks who the support is for, which areas it's affecting, and how soon they'd like to begin, then flags guardian consent and format preference so only session-ready leads land in your CRM.
Preview your self-esteem support intake
Explore 6 questions from the Self-Esteem Support template. This interactive preview uses illustrative scoring and sample attachments. Open the full survey to try the complete intake.
What a qualified self-esteem support lead should tell you
Individual therapy sessions focused on building self-worth and confidence, where intake needs to establish who the support is actually for, which life areas the low self-esteem affects, and whether the requester can legally consent to therapy before a session gets booked.
- This Support
- Areas Self-Esteem Concern Affect
- Person Received Therapy Or
- Soon Begin Sessions
- Parent Or Legal Guardian
- Preferred Session Format
The questions your team needs answered
Every self-esteem support intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Who is this support for? | Identifying whether the support is for the requester, a child, a partner, or another family member determines whether the guardian consent question applies before the lead can be treated as bookable. |
| Which areas does the self-esteem concern affect most? | Segments the lead so you can route, price, and prioritize it correctly. |
| Has the person received therapy or counseling before? | Knowing whether the client has prior therapy experience shapes how much orientation information staff need to prepare before the first intake session. |
| How soon are you hoping to begin sessions? | This answer directly drives urgency scoring, with 'This week' weighted well above 'Just exploring options' so your team can prioritize accordingly. |
| Are you the parent or legal guardian able to consent to therapy for this person? | A 'No' answer is weighted low because it signals the requester can't yet legally authorize therapy, which should stop a slot from being held until resolved. |
| What is your preferred session format? | Capturing format preference upfront lets scheduling staff offer the correct calendar type without a follow-up call. |
How Cliont scores self-esteem support leads
Configured answer weights help your team prioritize follow-up. Your team reviews each submission and decides the next step.
Value signals
- This week
- Within a month
- Just exploring options
- Parent Or Legal Guardian: yes
See an example lead handoff
Illustrative lead details and score show how a submission can reach your team.
Self-Esteem 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 self-esteem support workflows
| Cliont capability | Self-Esteem Support application |
|---|---|
| Conditional consent gating | When 'My child' or 'Another family member' is selected, Cliont surfaces the guardian consent question and flags 'No' answers for staff review before a slot is held. |
| Multi-select tagging | Answers to which areas the self-esteem concern affects (relationships, work, body image, etc.) are captured as structured tags your CRM can use to match a client to the right therapist. |
| Timeline-based lead scoring | 'This week,' 'Within a month,' and 'Just exploring options' answers are weighted differently so urgent intake requests surface above longer-nurture leads in your queue. |
| Format-aware routing | The in-person/virtual/no-preference answer is passed along with the lead so scheduling staff can immediately offer the right session type. |
Example self-esteem support lead scenarios
Illustrative situations explain the intake questions and possible follow-up.
Adult ready to start this week
A self-referred adult picks 'This week' for timeline and 'Myself' for who it's for, pushing the lead toward high priority with no consent question to resolve.
Parent inquiring for a child
The requester selects 'My child,' triggering the guardian consent question; a 'No' answer flags the lead for a conversation before any slot gets held.
Early browsing, no set timeline
Someone picks 'Just exploring options' and 'Not sure' for affected areas — still worth routing to CRM, but clearly a longer-nurture lead than a this-week request.
Referral for a partner's confidence
The person filling out the form selects 'My partner or relationship' as who it's for, which changes what your team needs to clarify before scheduling an intake session.
Returning client, virtual preference
A lead answers 'Yes' to prior therapy or counseling and picks 'Virtual' as format, letting your team skip orientation basics and go straight to scheduling.
Connect Cliont to your workflow
Connect your CRM
HubSpot, HighLevel, monday.com
Connect your legal software
Lawmatics, MyCase, Clio Manage and Clio Grow
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 individual therapy intake templates
Self-Esteem Support lead-intake FAQs
How does the intake handle someone filling out the form on behalf of a child or partner?
The 'Who is this support for' question captures that up front, so a lead submitted for a child automatically triggers the guardian consent question before it's treated as bookable.
What happens if a parent answers 'No' to the consent question?
That answer carries a low weight in scoring, so the lead is flagged rather than treated as session-ready — your team can follow up on consent before you hold a slot.
Does the timeline answer actually change how leads are prioritized?
Yes — 'This week' scores highest, 'Within a month' scores mid-range, and 'Just exploring options' scores lowest, so your CRM view reflects real urgency rather than submission order.
Can the intake tell me if this is a first-time therapy client?
The prior therapy or counseling question is captured on every lead, which helps your team decide whether to send onboarding materials before the first intake session.
How are multiple affected areas like body image and work performance handled?
That question allows multiple selections, so a lead can flag several areas at once and your team sees the full picture instead of a single generic reason for reaching out.
Does the intake ask about session format before I schedule?
Yes, the in-person vs. virtual vs. no-preference question is captured on intake so scheduling staff know which calendar type to offer without a back-and-forth.
Turn self-esteem support visitors into qualified patients
Give every self-esteem support visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.