Ear infection intake that asks what your team actually needs to know
Pet owners describe ear symptoms like discharge, scratching, or pain, note how long the issue has lasted, and flag whether it's a recurring problem, all with ear photos attached before the enquiry reaches you. Your team sees a scored, dermatology-ready lead instead of a vague ear complaint.
The exact intake your ear infection leads complete
This is the real 5-question guided intake for Ear Infection — the same flow your customers finish before you ever pick up the phone.
What a qualified ear infection lead should tell you
Intake for pets showing ear symptoms such as odor, discharge, scratching, redness, or pain, capturing which symptoms are present, how long they've lasted, and whether the pet has had ear infections before so you can tell a routine irritation from a recurring dermatology case.
- Symptoms Pet Showing In
- Long Has Pet Had
- This Pet Had Ear
- Animal Care
- Owner Or Authorized Caregiver
The questions your team needs answered
Every ear infection intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| What symptoms is your pet showing in the ear? | Selecting odor/discharge or pain signals an active, likely infected ear that needs prompt clinical attention rather than a routine check. |
| How long has your pet had these ear symptoms? | How long the symptoms have lasted distinguishes a sudden flare from a case that's been building, which shapes how quickly the appointment should be scheduled. |
| Has this pet had ear infections before? | A prior-infection history often points to an underlying allergy driving repeat flare-ups, which changes whether the visit needs a broader dermatology evaluation. |
| What type of animal needs care? | Dog, cat, and other-animal ear infections present and treat differently, so this determines which appointment type and clinician the lead should be routed to. |
| Are you the owner or authorized caregiver of this pet? | Confirming the submitter is the owner or authorized caregiver filters out inquiries you can't schedule or treat without proper consent. |
How Cliont scores ear infection leads
Every answer is weighted automatically — no manual review required.
Value signals
- Odor or discharge
- Scratching or head shaking
- Redness or swelling
- Pain or sensitivity when touched
- No visible symptoms, just concerned
- Owner Or Authorized Caregiver: yes
See the lead your team receives
Ear Infection 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 ear infection workflows
| Cliont capability | Ear Infection application |
|---|---|
| Weighted symptom scoring | Odor, discharge, pain, and redness selections score higher than a 'just concerned' answer, so active infections rise above vague check-in requests. |
| Recurrence flagging | A yes answer on prior ear infections combined with a 'recurring issue' duration answer surfaces patients who may need an allergy-focused workup rather than a one-off treatment. |
| Species-based routing | The animal type answer separates dog, cat, and other-animal cases so each can be routed to the appointment type and clinician suited to that species' ear infection presentation. |
| Ownership verification | The owner/authorized caregiver question lowers the score of submissions from non-caregivers, catching consent issues before a slot gets booked. |
Common ear infection lead scenarios
Recurring infection in an allergy-prone dog
Owner selects a recurring issue with prior infections plus odor/discharge and scratching, a pattern that often points to underlying allergy work rather than a one-time treatment.
Sudden onset, first-time case
Symptoms started today with redness, swelling, and pain, and the pet has no history of ear infections, a profile suited for a prompt first evaluation.
Concerned owner, no visible symptoms
Owner picks 'no visible symptoms, just concerned' with a lower weight than active symptom answers, so intake routes this toward a lower-priority follow-up rather than a same-day slot.
Cat or exotic pet inquiry
Selecting cat or 'other animal' changes what the intake surfaces, since ear infection presentation and treatment differ from the typical canine case.
Submission from a non-owner caregiver
Answering 'no' to the ownership question scores lower, flagging that consent or authorization needs confirming before booking an appointment.
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 pet dermatology and allergy intake templates
Ear Infection lead-intake FAQs
Does the intake tell me if this is a chronic ear problem or a new one?
Yes. The duration question and the prior-infection yes/no answer together show whether you're looking at a fresh flare or a pet with a recurring pattern that may need a broader dermatology workup.
Can the intake separate dogs, cats, and other animals?
The animal type question captures whether the patient is a dog, cat, or other animal, which matters since ear infection presentation and treatment protocols differ by species.
What happens when an owner isn't sure their pet even has symptoms?
Owners can select 'no visible symptoms, just concerned,' which carries a lower weight than active symptom answers, so those leads are still captured but scored differently from cases with visible discharge, redness, or pain.
Does the intake confirm the person submitting is actually the pet's owner?
Yes, the intake asks whether the submitter is the owner or an authorized caregiver, which affects the lead score and helps you avoid booking appointments you can't legally proceed with.
What photos or videos does the ear infection intake collect?
The intake is set up to collect a close-up photo of the affected ear and, when relevant, a short video showing head shaking or scratching, giving your team visual context before the appointment.
Can I spot recurring patients before they book?
The prior-infection question combined with symptom selections like odor/discharge or pain lets you flag recurring cases for a specialist review path instead of a general checkup slot.
Turn ear infection visitors into qualified patients
Give every ear infection visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.