Which fall risk enquiries deserve care assessment time
Ask whether the person has fallen in the past six months, capture which hazards - loose rugs, poor lighting, stairs without railings - are present, and confirm who can approve changes before you schedule a visit. Photos of stairwells and bathrooms come in with the lead so you know the safety picture before you walk in.
The exact intake your fall risk assessment leads complete
This is the real 7-question guided intake for Fall Risk Assessment — the same flow your customers finish before you ever pick up the phone.
What a qualified fall risk assessment lead should tell you
An evaluation of an older adult's fall history, current mobility aid use, and home hazards, used to determine what safety changes or care interventions are warranted and who can approve them.
- Person Fallen Or Nearly
- Requesting This Assessment
- Mobility Aid, If Any,
- Would This Assessment Mainly
- Person Have Authority Approve
- Safety Concerns Present In
- Soon Would Like Assessment
The questions your team needs answered
Every fall risk assessment intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Has the person fallen or nearly fallen in the past six months? | A recent fall or near-fall is the strongest single signal of urgency and severity for a fall risk case. |
| Who is requesting this assessment? | Knowing whether the older adult, a family member, or a care coordinator is requesting the assessment tells you who to expect on the call and how much context they'll already have. |
| What mobility aid, if any, does the person currently use? | Current mobility aid use points to which hazards - thresholds, bathroom clearance, stair width - are most likely to matter during the visit. |
| Where would this assessment mainly take place? | Whether the visit happens in a private home, assisted living, or nursing home changes what coordination and access you'll need to arrange in advance. |
| Does the person have authority to approve changes to the home or care plan? | If the requester can't approve home or care plan changes, any recommendations you make will need a separate sign-off before they can be acted on. |
| Which safety concerns are currently present in the living environment? | Each hazard selected adds its own weight to the score, so this answer does most of the work in separating a low-risk home from a high-risk one. |
| How soon would you like the assessment to happen? | Preferred timeline helps you sequence outreach and scheduling without overriding the underlying risk-based score. |
How Cliont scores fall risk assessment leads
Every answer is weighted automatically — no manual review required.
Value signals
- Person Fallen Or Nearly: yes
- Person Have Authority Approve: yes
- Loose rugs or clutter
- Poor lighting
- Stairs without railings
- Slippery bathroom surfaces
See the lead your team receives
Fall Risk Assessment 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 fall risk assessment workflows
| Cliont capability | Fall Risk Assessment application |
|---|---|
| Weighted multi-choice scoring | Each hazard selected in the living-environment question - loose rugs, poor lighting, stairs without railings, slippery bathroom surfaces - adds its own weight, so a home with multiple hazards scores higher even without a reported fall. |
| Conditional flagging | When the requester lacks decision-making authority over the home or care plan, the lead is still delivered but flagged, so you know to confirm approval before proposing safety changes. |
| Structured photo capture | Photos of staircases, bathrooms, and walkways are collected alongside the intake answers, giving you a visual check on hazard claims before the visit. |
| CRM routing with priority tagging | Leads combining a recent fall with high-weight hazards route to your CRM as priority, while exploratory, no-fall enquiries route as standard follow-ups. |
Common fall risk assessment lead scenarios
Recent fall, wants urgent visit
The person has fallen in the past six months and the family selected the soonest timeline option, putting this lead at the top of the queue alongside its hazard answers.
Family requests, no authority to change home
A family member submits the intake but indicates the older adult (not them) holds decision-making authority, flagging that any recommended changes will need a separate approval step.
Facility resident, no private home
The assessment location is an assisted living or nursing facility rather than a private home, which changes what hazard categories and coordination steps apply.
No fall yet, just researching
No recent fall is reported and the timeline is 'just exploring options,' producing a lower-urgency lead that's still worth nurturing rather than dropping.
Care coordinator referral with hazards flagged
A professional care coordinator submits the intake on behalf of a client and multiple hazards (stairs without railings, poor lighting) are selected, combining a credible requester with a high hazard score.
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 senior mobility and safety intake templates
Fall Risk Assessment lead-intake FAQs
If there's no recent fall but the home has several hazards, how does the intake score that lead?
The intake weighs each selected hazard - loose rugs, poor lighting, stairs without railings, slippery bathroom surfaces - independently of fall history, so a hazard-heavy home can still score as high value even without a reported fall.
What happens if the family filling out the intake can't actually approve home changes?
The decision-authority question captures this directly, so a lead from a family member without approval power is still routed to your CRM but flagged so you know a separate conversation with the decision-maker may be needed before recommendations can move forward.
Does the intake treat a private home differently from an assisted living or nursing facility?
Yes - the location question distinguishes private home, assisted living, and nursing home, so you can see upfront whether the visit involves facility staff coordination or a straightforward home visit.
How does the intake handle mobility aids like walkers or wheelchairs?
The mobility aid question tells you what the person currently uses - no aid, cane, walker, or wheelchair - so you can anticipate which hazards (thresholds, bathroom clearance, stair width) are most relevant before you arrive.
Does selecting 'as soon as possible' change the lead's score?
Timeline is captured to help you prioritize scheduling order, but the lead score itself is driven by fall history, hazards, and approval authority, so an urgent timeline doesn't override a lower-risk profile.
How is a fall risk assessment lead different from a home safety assessment lead?
Fall risk assessment centers on the person - fall history, mobility aid, and who can approve changes - while a home safety assessment lead (a sibling subservice) focuses more broadly on the physical environment regardless of an individual's fall history.
Turn fall risk assessment visitors into qualified patients
Give every fall risk assessment visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.