Know which pre-surgical evaluation leads are worth intake session time
Every enquiry captures the surgery type, whether the surgical team requires the evaluation, and current mental health care history — plus a surgeon referral letter — so you can see which requests are true intake-session candidates before you hold a slot.
The exact intake your pre-surgical psychological evaluation leads complete
This is the real 6-question guided intake for Pre-Surgical Psychological Evaluation — the same flow your customers finish before you ever pick up the phone.
What a qualified pre-surgical psychological evaluation lead should tell you
An assessment of a client's mental and emotional readiness for a specific surgery — such as bariatric, transplant, spinal, or gender-affirming procedures — that a surgical team typically requires before scheduling can proceed.
- Surgery This Evaluation
- Surgeon Or Medical Team
- Have Scheduled Surgery Date
- Evaluation Report Submitted Directly
- Receiving Care From Mental
- This Evaluation Yourself Or
The questions your team needs answered
Every pre-surgical psychological evaluation intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What type of surgery is this evaluation for? | Surgery type carries per-option weight, so higher-stakes procedures like organ transplant and gender-affirming surgery score differently than a general cosmetic request. |
| Has your surgeon or medical team requested this evaluation as a requirement? | A surgeon-mandated evaluation scores far higher than a self-initiated request, distinguishing near-certain medically necessary cases from ones that may need more qualification first. |
| Do you have a scheduled surgery date? | Knowing whether surgery is scheduled within a month helps your team decide which sessions need to be filled fastest, even though the timing itself isn't independently weighted. |
| Do you need the evaluation report submitted directly to your surgical team? | Confirms whether the finished report needs to be routed directly to the surgical office, so that delivery step can be built into the workflow before the session happens. |
| Are you currently receiving care from a mental health provider? | Reveals whether the client already has an established mental health provider, which shapes how much clinical background your team needs to gather during intake. |
| Is this evaluation for yourself or for someone you care for? | Distinguishes self-referrals from caregiver submissions on behalf of a dependent, changing who your team should actually be corresponding with before the session. |
How Cliont scores pre-surgical psychological evaluation leads
Every answer is weighted automatically — no manual review required.
Value signals
- Bariatric (weight-loss) surgery
- Organ transplant
- Spinal or chronic pain surgery
- Gender-affirming surgery
- Cosmetic surgery
- Other surgery
See the lead your team receives
Pre-Surgical Evaluation 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 pre-surgical psychological evaluation workflows
| Cliont capability | Pre-Surgical Psychological Evaluation application |
|---|---|
| Weighted lead scoring | Surgery type answers carry individual weights, so organ transplant, bariatric, and gender-affirming requests surface above lower-weighted cosmetic inquiries without manual review. |
| Conditional branching | When the surgeon-requirement question comes back 'No,' the record can be flagged as self-referred rather than medically mandated, helping you triage which sessions to prioritize first. |
| Document upload | Collects the surgeon referral letter or medical necessity form alongside the client's answer on whether the report needs to go directly to the surgical team. |
| Custom routing rules | Cases where the report must be submitted directly to the surgical team can be tagged for that delivery workflow the moment the intake is submitted, not after the session. |
Common pre-surgical psychological evaluation lead scenarios
Surgeon-mandated bariatric evaluation
Surgery type is bariatric and the surgical team has requested the evaluation, which scores among the highest-weighted combinations and typically needs a session booked quickly.
Organ transplant, report routing needed
Client is already in ongoing mental health care and needs the finished report sent directly to the transplant team, so the intake flags both the care history and the delivery requirement.
Self-referred cosmetic surgery inquiry
No surgeon has requested the evaluation and no surgery date is scheduled yet, which scores lower on the requirement question and may need follow-up before a slot is reserved.
Caregiver submitting for a dependent
The person completing the form is not the surgical patient but a family member arranging a gender-affirming or spinal surgery evaluation on someone else's behalf, changing who your team should be corresponding with.
Past care, no current provider
Client had mental health treatment previously but isn't currently under care, which shifts how much clinical background your intake needs to gather ahead of the session.
Connect Cliont to your workflow
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Notify your team
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Automate follow-up
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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 psychological testing intake templates
Pre-Surgical Psychological Evaluation lead-intake FAQs
Does the intake tell me whether a surgeon actually requires this evaluation?
Yes — the form asks directly whether the surgical or medical team has requested the evaluation, and that answer carries the highest scoring weight in the catalog, separating mandatory referrals from self-initiated requests.
Can the intake route the finished report straight to a surgical team?
The form asks whether the client needs the report submitted directly to their surgical team, so you know upfront whether a direct-delivery workflow needs to be built into the case before scheduling.
How does surgery type affect lead priority?
Surgery type is a single-choice question with its own per-option weight, so bariatric, organ transplant, spinal or chronic pain, and gender-affirming procedures score differently than a general cosmetic request.
What happens if the client doesn't have a scheduled surgery date yet?
The intake captures whether surgery is scheduled within a month, further out, not yet scheduled, or unknown, so you can see timing context even before you decide how urgently to hold a slot.
Does the form ask if the client is already seeing a mental health provider?
Yes — clients indicate whether they're in ongoing care, had past care, or have never received care, which helps you gauge how much clinical history your team will need to gather during the session.
Can this intake handle someone submitting on behalf of a family member?
Yes — the form distinguishes between an evaluation for the client themselves versus one for a dependent or family member they care for, so your team knows who to correspond with before scheduling.
Turn pre-surgical psychological evaluation visitors into qualified patients
Give every pre-surgical psychological evaluation visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.