AI Concierge · Intake

AI Concierge Intake

Tell me about your practice and I’ll build your AI Concierge in 72 hours. After review I’ll follow up with next steps and a payment link if we’re a fit.

1 · Practice Information

Practice Name *Practice Website *

City *State *

Type of Practice *

Plastic/Cosmetic SurgeryMed SpaDermatology

Other:

2 · Primary Contact

First name *Last name *

Role at the practice *

Email *Phone

3 · Current Systems & Workflow

Do you currently use any of the following? *

EMR / EHROnline BookingPatient PortalCRM / Lead TrackingAI tools

Other:

What is your biggest bottleneck in your front-office workflow? *

4 · AI Goals & Interests

What would you most like AI to help with? *

Automating patient inquiriesReducing front-desk workloadImproving response timeScheduling & remindersInsurance / pre-qual questions

Other:

If you could wave a magic wand and fix one thing with automation, what would it be? *

5 · Timeline & Future Intent

Timeline *

ASAPWithin 30 daysWithin 3 monthsJust exploring

Ongoing or one-time? *

One-time setup onlyOccasional check-ins and updatesMonthly or long-term supportNot sure yet

Which Concierge package are you interested in? *

Standard – $300Premium – $500Not sure yet – help me decide

6 · About You

Comfort with AI tools

I use them regularlyI've tried them but need helpI'm brand newI don't know what's possible

What kind of help are you looking for?

Build a specific toolMake my current system work betterIntegrate AI into website/emails/formsJust show me what's out there

Someone on your team who can manage the AI after build?

Yes, I/my team can take overPrefer ongoing helpNot sure yet

What you’re applying for

AI Concierge build.

Build time: 72 hours
Standard tier: $300 USD
Premium tier: $500 USD

What you’ll get

Automated lead follow-up workflow
Review reply assistant in your voice
Email + text draft generator
Custom FAQ responses
Cold lead reactivation prompt
Setup guide; plug-and-play in ChatGPT

Submitting this form is not a purchase. I’ll review fit first, then send a payment link only if we’re aligned.

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