Working demonstration · Medical & wellness

Front-desk intake: reason → urgency → appointment need

Structured capture for clinics and practices—so after-hours and overflow calls become reason for visit, urgency, and a callback the front desk can act on.

Contact & urgency

Who is reaching out and how fast someone should respond.

Name

Phone

Email (optional)

Company name on the form (demo)

Address / location (optional) Urgency

Urgent (same day — not 911) Soon (1–2 days) Schedule when convenient

Visit context

New or established patient, and what kind of visit.

Patient type

Visit type

Preferred provider (optional) Insurance / coverage notes (optional) Anything else we should know?

Reason for calling (most front desks)

Pick all that apply—the same short list staff hear all day.

Other / more detail

What do they need next?

Appointment, refill callback, records, or triage.

Goal

Preferred window

Access / callback notes Other expectations