Post-hospital care intake that asks what your team actually needs to
Ask about discharge status, the type of home support needed, and whether a doctor's follow-up care plan is in place, then collect discharge paperwork upfront so your team knows the case before the first call.
The exact intake your post-hospital care leads complete
This is the real 6-question guided intake for Post-Hospital Care — the same flow your customers finish before you ever pick up the phone.
What a qualified post-hospital care lead should tell you
Short-term, doctor-directed support for a person returning home after a hospital stay, covering personal care, mobility, medication reminders, and recovery monitoring until they're stable on their own.
- Person Been Discharged From
- Main Reason Care Needed
- Support Person At Home
- Person Have Follow-Up Care
- Completing This Request
- There Family Member Or
The questions your team needs answered
Every post-hospital care intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Has the person been discharged from the hospital or is discharge upcoming? | Discharge timing carries the heaviest weight in the catalog, so it's the clearest signal of how soon your team needs to be ready to start care. |
| What is the main reason care is needed after the hospital stay? | The reason for care doesn't carry a weight but helps route the case to staff experienced with surgical recovery, illness, or injury-specific needs. |
| What type of support does the person need at home? | Wound and recovery monitoring is weighted well above companionship, so the selected support needs reveal whether this is a clinical case or a lighter one. |
| Does the person have a follow-up care plan or instructions from a doctor? | A confirmed follow-up care plan scores higher because it means your team has clear medical direction to work from instead of starting from scratch. |
| Who is completing this request? | Knowing whether a family member, the patient, or a case manager submitted the request shapes how your team should approach the first outreach. |
| Is there a family member or caregiver available to help coordinate care? | Whether a caregiver is available to help coordinate care flags families who may need more hands-on support setting up the care plan. |
How Cliont scores post-hospital care leads
Every answer is weighted automatically — no manual review required.
Value signals
- Already discharged
- Discharge expected soon
- Still hospitalized, no discharge date yet
- Personal care (bathing, dressing)
- Mobility assistance
- Medication reminders
See the lead your team receives
Post-Hospital Care 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 post-hospital care workflows
| Cliont capability | Post-Hospital Care application |
|---|---|
| Weighted answer scoring | Already-discharged and discharge-expected-soon cases score higher than still-hospitalized inquiries, so your team can prioritize the ones ready to start. |
| Multi-select qualification fields | Support-need selections like wound monitoring and mobility assistance carry more weight than companionship-only, separating skilled-need cases from lighter ones automatically. |
| Conditional flagging | When a family reports no caregiver available to coordinate care, that case can be routed for a more detailed intake call before assessment. |
| Document collection during intake | Families are prompted to upload hospital discharge paperwork and follow-up care instructions so your team reviews the medical context before the first assessment. |
Common post-hospital care lead scenarios
Already discharged, no plan yet
The person is home now but the family hasn't received written follow-up instructions from the hospital, so the intake flags this as urgent while noting the missing care plan.
Discharge coordinator planning ahead
A hospital case manager submits the request before discharge day, listing wound monitoring and mobility assistance so staffing can be lined up in advance.
Still hospitalized, exploring options
A family is researching care before a discharge date is even set; the intake captures this as an earlier-stage lead without treating it as immediate.
Solo senior, no caregiver nearby
Support needs include medication reminders and wound monitoring, but no family member is available to coordinate care, signaling the family will need extra hand-holding after intake.
Companionship-only request
The family selects companionship as the only support need, which the intake weights lightly compared to personal care or wound monitoring, helping staff triage accordingly.
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 home health care intake templates
Post-Hospital Care lead-intake FAQs
What happens if a family submits the form before the hospital has confirmed a discharge date?
The intake still accepts the submission and records it as 'still hospitalized, no discharge date yet,' which scores lower than a confirmed discharge but keeps the family in your pipeline for follow-up once a date is set.
Can the intake tell the difference between a wound-care case and a companionship-only request?
Yes. The support-needs question is multi-select, and wound or recovery monitoring carries far more weight than companionship, so cases needing closer clinical attention surface higher than lighter requests.
Does it matter if the family doesn't have written discharge instructions yet?
The follow-up care plan question is a simple yes/no, and answering yes scores higher than no, since a documented plan means your team can start care faster with clear direction from the hospital.
Does the intake distinguish between a family member, the patient, and a hospital case manager submitting the request?
Yes, the 'who is completing this request' question captures that context, which helps your team tailor the first outreach differently for a direct family inquiry versus a professional discharge referral.
How do you flag families who will need extra help coordinating care after discharge?
The intake asks directly whether a family member or caregiver is available to help coordinate care, so cases with no one available can be routed to staff who handle higher-touch support.
Is this intake set up to take referrals directly from hospital discharge planners?
Yes, care coordinators and case managers are one of the listed submitter types, so referrals from hospital staff are captured the same way as family-initiated requests.
Turn post-hospital care visitors into qualified patients
Give every post-hospital care visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.