What is in a lead

• Full name (one field)
• Phone number
• Email address
• State (as the patient confirmed or picked it)
• The state their IP address points to
• Program (weight loss)
• Weight loss goal
• Self pay answer (always yes, since a no stops the lead)
• Health screen answer (always passed, since a yes stops the lead)
• Submission time (in UTC)
• Consent record (below)
• A unique ID for the submission

[CONFIRM: that every field above reaches the clinic by webhook, by email and in the Google Sheet]

Today the form is for a weight loss program. The patient starts by picking a weight loss goal: under 20 lbs, 20 to 50 lbs, 50 to 100 lbs, or over 100 lbs.

• They agree to pay directly. The form tells them the program is not billed through insurance and that consultations are paid directly, and asks if that is okay. A no stops the lead.
• They pass a short health screen. It asks whether any of these apply: a personal or family history of medullary thyroid cancer or MEN2; being pregnant or breastfeeding, or planning to become pregnant; a history of pancreatitis. A yes to any of them stops the lead.
• They confirm their state. The form suggests one from their IP address, and they confirm it or pick their state from a list. If their IP points to a blocked state, or they pick one, the form stops them. Today the blocked states are Maine and Rhode Island.
• They give a name, a 10 digit phone number and an email address. The form checks that each one is filled in and in the right format.
• They agree to calls and texts by ticking a box. The form will not submit without it, and our server rejects any lead that arrives without it.

The form does not check for duplicates or call the number to verify it. A duplicate within 30 days, or a fake or disconnected number, is a bad lead: flag it within 72 hours and it is replaced or refunded. [CONFIRM: whether duplicates are filtered out after submit, before a lead is sent to the clinic]

• Consent to calls and texts, recorded as yes.
• The exact consent text they saw, word for word.
• A version label for that text.
• The time their browser sent the form and the time our server received it, both in UTC.
• The IP address our server saw the form come from.
• Their browser details.

The consent record shows when and how the patient agreed to be contacted.

It goes by webhook to your CRM, by email, or to a Google Sheet. Any or all.

Right after they submit, the form tells the patient their phone is about to ring about the consultation they asked for.

• Not a booked appointment. The patient asked to be contacted, and no time is booked yet.
• Not a guaranteed patient. We sell leads, not closed patients. A real patient who doesn't pick up or doesn't buy is not refunded.
• Not shared or resold. One patient, one clinic, one time. Never shared at the moment of delivery and never resold later as aged data, at any age, at any price.

See pricing for what a lead costs and how bad leads are replaced.