Let's configure
your AI phone agent.

Complete this form before your kickoff call. We'll use your answers to pre-configure your agent — so we can skip discovery and go straight to deployment.

Practice Information

Practice Name *

Specialty *

Primary Contact *

Title / Role

Email *

Phone

Number of Locations

Number of Providers

Providers — list names and titles, one per line

Call Volume & Hours

Estimated Monthly Call Volume

% of Calls Missed / Unanswered

Office Hours — include all locations if different

After-Hours Handling *

Route to voicemail AI agent collects intake and notifies staff next morning Route urgent calls to on-call provider Other (describe in notes)

Languages Needed Bilingual support available

English Spanish Mandarin Vietnamese Tagalog Arabic Other

Call Routing & Departments

Which departments should the agent route to? — check all that apply

Scheduling — new and existing appointments Nursing / Clinical triage Billing / Insurance Rx Refills Surgery Coordination / Pre-op / Post-op Audiology Allergy Sleep / Sleep Studies Referring Physician Priority Line

How are calls currently handled? *

Appointment Booking Preference

Technology & EMR

EMR / Practice Management System *

EMR Integration Priority

Current Phone / VoIP System

Phone Number for Agent

Clinical Content & Agent Voice

Common reasons patients call — helps train routing logic

Specific questions the agent should answer

Preferred Agent Tone

Warm & conversational Formal & professional Efficient & brief Friendly & reassuring

Preferred Agent Greeting — we'll customize this

Additional Notes

The more context you provide here, the faster we can go live. Share anything about current pain points, prior technology experiences, or specific concerns.

Anything else we should know?

What does success look like in 90 days?

Your responses are reviewed by the Surgery.AI team before your kickoff call.

✓ Submitted — we'll review your responses and follow up before your scheduled call.

Surgery.AI · AI Infrastructure for Surgical & Specialty Practices

Let's configureyour AI phone agent.

Let's configure
your AI phone agent.