The demand for telehealth services in the United States saw an unprecedented increase following the 2020 COVID-19 pandemic. Prior to the pandemic, intake and virtual rooming functions for scheduled, synchronous video appointments at Mayo Clinic were supported by a small centralised team of virtual agents within its Center for Connected Care (Connected Care). In response to the pandemic-generated demand, Connected Care leveraged its existing model and the support of temporary staff to rapidly scale support for the increased video visit demand across the enterprise. Once demand stabilised in the summer of 2020, Mayo Clinic’s destination medical centres in Minnesota, Florida and Arizona, and Mayo Clinic Health System’s sites in the Midwest, launched pilots to evaluate alternative telehealth delivery models. The goal of these pilots was to test the flexibility of alternative intake models for supporting long-term scalability and growth. Through these pilots, each site developed unique workflows and staffing plans with the overall intake function remaining standardised across all locations. The workflows delineated responsibilities between clinical departments and virtual agents, leveraged current infrastructure and maximised best practices from the original model. This paper outlines the models implemented, and presents lessons learned and best practices garnered from each implementation.