Lead capture pattern, built
A consult request that checks insurance first.
A personal injury case often lives or dies on whether there is real insurance coverage behind it, not just who was at fault. This pattern asks that question up front, so the first real call can start from an informed place.
- A single build fee, part of your site, from $1,500
- $0 setup, no case-intake software fee
- 30-day guarantee, pay only if it works
How the form works
Incident, treatment, coverage, one flagged intake.
The questions it asks
The visitor picks an incident type, like an auto accident or a slip and fall, notes whether they have already seen a doctor, and answers what they know about insurance, whose policy it might be, or simply not sure yet. A short account of what happened closes the form.
The logic behind the answer
No price or outcome shows anywhere, since a firm working on contingency does not charge unless they win, and no honest firm can price or predict a case sight unseen. The form's real job is triage: sorting whether there appears to be coverage and a case worth a real consult.
Where the lead goes
A completed form reaches the intake team with incident type, treatment status, and insurance status flagged clearly, so the first call can start with the right questions instead of starting from zero.
What happens when nobody picks up
A fallback text or call goes out inside a short window, since many injury claims run against a filing deadline that varies by state or province. A slow intake process risks more than a lost lead here.
Why an insurance check matters in this intake
It screens for coverage before anything else
A case with no available insurance coverage often is not viable no matter how clear the fault looks. Asking about coverage early keeps the first real conversation focused on cases the firm can actually help.
It avoids promising an outcome or a number
A law firm cannot ethically price or predict an injury case sight unseen, and advertising rules in most states and provinces restrict that kind of claim. The form is written to describe the process, not the result.
It asks about treatment for a reason
Documented medical treatment is part of what makes a claim provable later. Asking whether the visitor has already seen a doctor helps the intake team understand where the case actually stands.
It treats the intake as time-sensitive
Injury claims run against filing deadlines that vary by jurisdiction, unlike most other lead types in this family. That is why the fallback here is tuned tighter than a form for a non-urgent estimate.
How we build this into your site
01
We learn your real intake questions and case types
We work from the case types your firm actually takes and the specific questions your intake team already asks on the phone, so the form matches your real process.
02
We build and test the consult request form
The form ships as a real page on your new site, written in plain language, since someone filling this out after an accident is often stressed and should not have to decode legal terms to answer it.
03
We connect it to intake with tighter escalation timing
The finished request reaches whoever runs intake, and we set the follow-up window tighter than other lead types in this family, given how filing deadlines can affect a case.
Consult request with insurance check, answered
That depends on the firm using this pattern, and we build the page to state their real policy plainly rather than assume one for them.
The form still captures that answer as not sure or none, and it is flagged for intake to review rather than treated as a reason to reject the request automatically.
The form still accepts the request. It simply flags that detail for intake, since it can affect how they advise the person to proceed.
We set the fallback window tighter here than for most other lead types in this family, given how filing deadlines can work against a slow response.
Personal injury law firms and similar practices where insurance coverage and treatment status shape whether a case moves forward. We adapt the case types and questions to the firm.
Want this built for your firm?
Tell us the case types you take and your real intake questions, and we will scope a consult request form around your process as part of a one-time website build. You hear back with a proposal in one business day.