Qualify every senior care lead before the first conversation
Families researching senior care rarely know which service fits — Cliont's intake asks about the care recipient's needs, current living situation, and timeline, then routes the qualified lead straight to your CRM with the right subservice tagged so your team calls back prepared.
Browse every senior care intake template
Each category ships ready-to-embed, job-specific intakes — open any to try the exact experience your leads complete.
Non-Medical Home Care
Preview 8 intake templates for non-medical home care, including meal preparation, overnight care, personal care assistance.
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Senior Mobility and Safety
Preview 5 intake templates for senior mobility and safety, including mobility equipment consultation, medical alert system, home safety assessment.
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Adult Day Services
Preview 5 intake templates for adult day services, including transportation to day program, social day program, memory day program.
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Assisted Living
Preview 5 intake templates for assisted living, including medication assistance, assisted living placement, daily living support.
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Home Health Care
Preview 6 intake templates for home health care, including medication support, occupational therapy at home, physical therapy at home.
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Memory Care
Preview 5 intake templates for memory care, including behavioral support, caregiver respite, memory care placement.
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Hospice and Palliative Care
Preview 6 intake templates for hospice and palliative care, including family caregiver support, home hospice care, inpatient hospice care.
View intakes →Information senior care teams need before the first conversation
Across every senior care service, Cliont intakes are built to capture:
Senior Care covers the full range of services families search for when helping an aging parent or relative stay safe and supported, from non-medical home care and mobility support to assisted living, memory care, home health care, adult day services, and hospice or palliative care — each with its own care level, urgency, and family circumstances that a lead intake needs to sort out before a care assessment is booked.
- This Meal Preparation Help
- Person Have Any Dietary
- Often Meal Preparation Help
- Will Meals Be Prepared
- Have Legal Authority Arrange
- Soon Meal Preparation Help
- There Specific Foods Or
- This Overnight Care
- Overnight Support Needed
- Many Nights Per Week
How senior care lead scoring works
Every answer across every senior care intake is weighted automatically.
Value signals
- Daily
- Several times a week
- Weekly
- Occasional or as-needed
- In the person's own home
- In a family member's home
Urgency signals
- Immediately
- Immediate daily use
- Person Had Fall Or
- Waterproof for shower use
- Planning ahead, no urgent date
- Sundowning (evening confusion)
Route leads by service, area, urgency, and value
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
Senior Care lead-intake FAQs
How does Cliont tell the difference between a home care lead and an assisted living or memory care lead?
The intake asks about the care recipient's current living situation, level of independence, and any cognitive or medical concerns, then routes the enquiry toward the matching subservice — home care, assisted living, memory care, or another sibling service — so your team isn't the one sorting that out on the phone.
Our agency handles multiple senior care services. Can one intake cover all of them?
Yes — Cliont builds a separate qualification flow for each subservice you offer (non-medical home care, senior mobility and safety, adult day services, assisted living, home health care, memory care, hospice and palliative care), and families are directed to the right one based on their answers.
Adult children usually fill out the form, not the senior themselves. Does the intake account for that?
The intake is built around a family member describing someone else's situation, so questions are phrased for a caregiver or adult child answering on behalf of a parent or relative, not the care recipient.
How urgent are most senior care enquiries, and does the intake reflect that?
Timelines range from immediate needs after a hospital discharge to families planning months ahead, and the intake captures that urgency so time-sensitive leads reach your CRM flagged differently than early-stage research enquiries.
What happens if a family's needs fall outside what our agency provides?
If the intake surfaces needs your agency doesn't cover — a higher level of medical care, for example, or a service like hospice that you don't offer — that's flagged so your team can redirect the family rather than booking a care assessment you can't fulfill.
Does the intake ask about payment source or insurance for senior care leads?
Where relevant to a specific subservice, the intake can ask about payment method or coverage so your team knows upfront whether a family is private-pay, using long-term care insurance, or exploring other funding before the care assessment call.
Turn your senior care traffic into booked patients
Give every visitor a guided, bilingual intake — and meet a scored, qualified lead before you pick up the phone.