Contact Wizard – Chiropractor Lead Form

Last updated: April 23, 2026 · 2 min read

Purpose-Built Chiropractic Lead Capture for WordPress

M Media Chiropractor Contact Wizard is a professional multi-step lead capture plugin for chiropractic practices, built to collect the detailed patient and clinical information you actually need – without requiring a CRM subscription, form builder, or third-party service. The wizard walks visitors through structured steps covering pain location, cause or onset, prior treatment, and insurance coverage. Every submission is stored in your WordPress dashboard and delivered to your inbox. No monthly fees. No lead-sharing. Your leads stay yours.

Why M Media Chiropractor Contact Wizard Exists

Generic contact forms collect a name and email. That is not enough to have a productive first conversation with a chiropractic prospect. You need to know where the pain is, whether it stems from an auto accident, workplace injury, or chronic condition, and whether they have insurance before you can prepare the intake and staff the appointment. M Media Chiropractor Contact Wizard solves this by design. It gives every patient a guided, professional experience while giving you a complete intake record before you ever pick up the phone.

M Media Chiropractor Wizard replaces a flat contact form with a guided quote-request wizard tailored to this service category.

Why a wizard?

A flat contact form asks for minimal information. This wizard qualifies the lead before your team follows up, so you spend time on serious prospects instead of incomplete requests.

What it does:

  • 5-step guided wizard – Collects request details, scope information, contact data, and confirmation in a structured flow.
  • Lead qualification – Captures the details your team needs up front so follow-up can be faster and more accurate.
  • Optional reference uploads – Supports customer file/image uploads when enabled in the plugin flow.
  • HTML email notifications – Your team receives a branded summary email with submitted details.
  • Lead management – Every submission is stored as a WordPress custom post type (ccw_lead) in the admin.
  • Fully customizable – Change intro text, success message, notification email, and question labels from settings.
  • SMTP support – Configure SMTP delivery or fall back to wp_mail().
  • Spam protection – Honeypot field plus minimum submission time checks.

Shortcodes:

[chiropractor_wizard] or [mmedia_chiropractor_wizard]

Place either shortcode on any page or post.

Installation

1. Upload the mmedia-contact-wizard-chiropractor folder to /wp-content/plugins/.

2. Activate the plugin through Plugins -> Installed Plugins.

3. Go to the plugin settings page in WordPress admin to configure notification email and wizard options.

4. Add [chiropractor_wizard] to any page.

Requirements

  • WordPress 5.8+
  • Tested up to WordPress 6.9
  • PHP 7.4+

Shortcodes

  • [chiropractor_wizard]
  • [mmedia_chiropractor_wizard]
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