Prospective Client External Form
We are pleased to announce the rollout of a newly designed Contact Us form in the CS360 platform, aimed at streamlining the prospective client intake process with enhanced configurability, usability, and validation features.
The form is titled “Contact Us” and adapts dynamically based on the selected relationship to the client (Self or Others). For configuration of the fields in the form you can go to the Prospective Client Form Settings, kept under the client agency settings.
Prospective Client Form fields explanation -
The form now starts with “Relation to Client”:
Choose “Self” if the person filling the form is the one needing care.
Choose “Others” if someone is filling it on behalf of the client (like a family member).
Depending on the selection, the form dynamically adjusts the fields, keeping it clean and relevant.
You now have a structured form that collects (for relationship set as self)
Basic Details
First Name & Last Name
Gender
Phone Number (Mobile by default)
Email Address
Address Information
Address Lines 1 & 2
Zip Code, City, State, and Country
(Zip Code is used to validate and auto-fill location, where possible.)
Additional Info About the Care Need
Preferred Services
Where they heard about your agency
Best time to contact
How soon care is needed
Estimated hours of care needed (with frequency options: One Time, Per Week, etc.)
Level of care required
Reason for care (e.g., Hospitalized, Home Help)
Notes (optionally include medical history or other helpful info)
Consent and Captcha are kept at the bottom. Clicking on the submit button will create a prospective client profile in your system with the form attached in the documents and the details are added to the profile.
If the relationship is set to other than self, contact details are added as below
The form will collect Caller’s Name, Phone, and Email separately.
The Client’s details (who needs the care) are still captured below.
Contact Information (Office Contact Information)
Office Contact Information is displayed as below
Prospective Client Form Settings
Agencies can now collect inquiries from potential clients using a customizable, public-facing form. Similar to the caregiver application, this form can be shared via a unique agency-specific link. Upon submission, a Prospective Client profile is automatically created in the system and relevant users are notified.
Unique external form link
A unique external link is generated for each agency.
Available under:
Admin Settings > Client > Prospective Client Form Settings (Contact Us)
Clicking the link opens the form in a new browser tab for easy sharing.
Field Configuration Settings –
Each form field can be individually marked as:
Mandatory: Required to submit the form.
Optional: Visible, but not required.
Disabled: Hidden from the form.
Configurable Sections:
Contact Information (used when relation is Other than Self):
First Name, Last Name, Phone Number, Email
Client Information (for Self):
First Name, Last Name, Gender, Phone, Email
Address Information:
Address Line 1, Zip Code, City, State, Country
Additional Info:
Preferred Services (with category checkboxes)
Where did you hear about us?
Best Time to Contact
How Soon Should Care Begin
Estimated Hours
Level of Care
Reason for Care
When Address is marked Mandatory, the form requires Address Line 1, Zip Code, City, State, and Country to proceed.
Note – Client First Name and Client Last Name will always remain as a mandatory field in the Contact Us form.
Contact Information Logic Based on Relationship to Client
If the relationship is marked as Other than Self, the Contact Information fields are shown and respected as per your settings.
If the relationship is Self, Contact Information is hidden.
Contact Us Section (Office contact details)
Can be toggled Enabled/Disabled in the settings.
If enabled:
The agency can choose which office(s) appear on the form.
Each selected office displays its name, phone number, address, and email.
Consent Settings
The Consent checkbox can be enabled or disabled.
If enabled, form submission requires consent to be checked by the user.
Appears at the bottom of the form.
Email Notification to the Agency User(s)
Users configured in Office Settings > Notifications > New Prospective Client receive an email.
Uses this template:
Template Name: Consumer Lead - Manual - Agency Template
Subject: New Prospective Client Lead
An acknowledgment email is also sent to the submitter.
Status Update on the Prospective Client Profile
Default three statuses for the Prospective client are introduced in the CareSmartz360. These statuses consists of Active (Active Lead), Converted (Converted to client), and Non-Converted (Prospective Client which are not converted).
You can find these statuses on Prospective Client Listing (New UI), Edit Profile Main tab. By default any prospective client that is active and not converted yet is displayed as Active, any prospective client that is converted is displayed with converted status, and any prospective client that is set to non-converted is set as non-converted status.
You can manage the status from the client DDM. The default statuses are non-editable and cannot be deleted. Any new status that will be added will be treated equivalent to non-converted status for the prospective client.
When you select the status of prospective client as Converted this will convert the prospective client to client if all the required fields for conversion are added. You can also mark a prospective client as non-converted by selecting this status, adding up the reason which is mandatory and can select the date. Date if not added will be considered as today’s date.
You can also view the listing of all type of prospective client in the listing by selecting the status filter as “All”.
Combined View for Caller and Client Information
With the new profile launch for the prospective client, we are excited to inform you that now you can access/add/modify the caller and client information from a single screen. Caller information will now only be displayed if the relation to client is selected as other than self.
In case if relationship to client is selected as self only the client information is displayed so that the duplicate information is not added to the profile.
In case Relation to Client is set as “Self” below information is displayed on the add prospective client -
In case the relation to the client is selected as “Other than self”, the below information is displayed in the General Information section with combined view of caller and client.
Addition of the Forms section to the Prospective Client Profile
We are excited to launch the forms for the Prospective Client profile with new user interface.
Filters and Search for Forms Grid
A search bar has been added to the top-left corner of the Forms page.
The search initiates automatically after entering minimum 3 characters.
Currently supports search by Form Name.
A dropdown menu titled "All Form Statuses" has been added beside the search icon.
Includes the statuses: "In-Progress" and "Completed".
Filter Buttons:
Apply: Applies selected form status filters to the data grid.
Reset: Clears filters and resets the grid to show all form statuses.
Add Form functionality
Clicking on the "Add" button opens a dropdown with search functionality.
Only Active Client Forms created under Settings are listed.
Selecting a form template triggers a pop-up for data entry.
Once saved or completed, the form appears in the listing grid.
Forms Listing
The forms listing grid now includes the following columns:
Checkbox Column:
Enables bulk delete for "In Progress" forms only.
Completed forms do not show checkboxes and are not deletable.
Name:
Displays form name.
Click to open the form with pre-filled data.
Modified:
Shows last modified date/time and user details.
Form Status:
In Progress: Set when “Finish later” or “Submit” is clicked.
Completed: Set when “Complete” is clicked.
Signature Status:
Never Requested: No request sent.
Pending Signatures/Total Sent: Clickable to open a grid view.
Completed: All required signatures received.
N/A: No signature fields in form.
Action Column Features
Signature Request:
Displays errors if no user/entity is assigned.
Sends email requests when valid signature fields are assigned.
Uses same behavior as existing “Client Profile” signature flow in the new UI.
Eye Icon: Displayed for completed forms only.
Delete Icon: Triggers a confirmation pop-up before deletion.
Edit Icon: Opens form for editing.
Signature Field Management in Prospective client forms
Signature fields have an edit icon to assign a user (Prospective Client or Contact).
Only users with an email address can be assigned.
Checkbox disabled for users without emails.
Combined view for Caller, Referral and Client Tab
The Caller tab, Referral tab, and Client tab are now combined into a single tab including major required information from these section. The caller details will only be displayed when relation to client is selected other than “Self”. The details for Caller displayed are “Caller First Name”, “Caller Last Name”, “Caller Phone”, and “Caller Email”. Client details are also available in the General Information section under the Main Tab.
Lead Source and Referral details are also merged in the Main tab.