Text messaging for healthcare
2-way texting for healthcare practices, built for HIPAA compliance
Spruce lets your team text over 2-way SMS directly from your practice phone number, or easily switch to secure messaging for more sensitive conversations. All texts, calls, faxes, and video visits stay organized in one unified patient thread, backed by automatic BAA coverage, to keep your team aligned and compliant.
14-day trial. No credit card required. Month-to-month billing. Cancel anytime.
Trusted by 50,000+ healthcare professionals
Why practices text with Spruce
Meet your patients where they already are: over text
Patients want to text their provider. Without the right tools, practices get stuck in phone tag, or text from personal devices and create compliance gaps. Spruce gives your team a professional and shared way to text patients, with the safeguards for HIPAA-compliant communication built in.
Reach patients where they are
Text from your practice number
Patients text your Spruce number from their phone's own messaging app. Send photos, PDFs and links, or start a group text with up to 10 people.
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One shared inbox
Texts, calls and voicemails land in one inbox the whole team can see, on mobile or web. Assign, add internal notes, and hand off, seamlessly, behind the scenes.
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Go secure for sensitive care
Invite patients to secure, app-based messaging for confidential conversations. Messages, photos and documents stay encrypted in transit and at rest.
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Compliance without the hassle
Every eligible Spruce organization automatically receives a BAA.* Sender ID and opt-out instructions are added to texts automatically, and every message is available in your inbox.
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Respond to patients faster
Missed-call text-back
Callers who don't reach you get an automated text right away, so the conversation keeps going.
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Scheduled Messages
Queue appointment reminders and post-visit follow-ups to send later, so nothing gets forgotten.
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Auto-replies
Answer after-hours texts instantly, so patients know what to expect.
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Bulk messaging
Send closures, flu shot reminders or policy updates to a patient list, each as a one-to-one text.
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* Note: Customers can't send outbound SMS texts during a trial until you register your number.
Get started with texting patients
Patient preference
Standard SMS can be part of HIPAA-compliant communication when the patient understands its limits, knows you offer a secure option, and still prefers to text.
Can you text patients in a HIPAA-compliant way?
Register your number
Carriers require your practice number to be registered before you send texts. Spruce's support team walks you through it.
How to register your business phone number
Compare tools
Google Voice has no carrier registration (A2P 10DLC) path for business texting, even on paid Workspace plans, so it can't support automated patient texting. See how Spruce stacks up feature by feature.
Spruce vs Google VoiceSpruce vs RingRx
missed callers now text instead
of no-show patients reschedule right away over text
of incoming calls now handled by text
Results from Kynetex Sports Care andTampa Bay Area Counseling
Case studies
See how practices text with Spruce
Spruce checked off all the boxes, and then some. I appreciated its ability to handle all of our needs — giving patients an omnichannel way to communicate with the practice.
Michael InguiOwner, Kynetex Sports Care
Kynetex Sports Care replaced a stand-alone texting tool, a phone carrier and a call center with Spruce. With missed-call text-back and proactive texting, admin phone time across 11 locations dropped from 30 hours a week to about 10.
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Tampa Bay Area Counseling now handles more than half of incoming calls by text and replies to missed calls within five minutes.
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Life Insight's clinicians each manage their own line and SMS texting for quick client updates and rescheduling, cutting time spent on client communication by 30%.
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At Beyond the Storm Behavioral Health, a shift to text-first communication gives each team member back about two weeks a year.
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Frequently asked questions
Can texting be part of HIPAA-compliant communication?
Yes, with the right setup. Standard SMS travels over the public telecom network, so no vendor can guarantee its security end to end. It can still be used in a HIPAA-compliant way when the patient understands those limits, knows you offer a secure alternative, and prefers standard texting. Spruce's Help Center includes a consent template you can adapt to document that preference.
Is there a texting app that is HIPAA compliant?
Spruce is built for HIPAA-compliant communication. 2-way SMS texting and secure app-based messaging are both available with Spruce, and every eligible organization gets a BAA as a part of the terms of service. Secure app-based messages are encrypted in transit and at rest, and the texts, calls, voicemails and faxes stored in Spruce are encrypted at rest.
Do I need a BAA to text patients?
If your texts include protected health information, your texting vendor should sign a BAA. With Spruce you don't have to request one: the BAA is part of the terms of service for every eligible organization and applies from the day the account is created, including during the free trial. Note that you can't send outbound SMS texts during a trial until you register your number.
Do patients need to download an app?
No. Patients can call and text your practice from their existing mobile number. Patients who want secure app-based messaging or video visits can use the free Spruce app on iOS, Android or web.
How long does it take to start texting?
Carriers require every practice to register its number before sending texts. Spruce's support team guides you through it: 95% of registrations are approved on the first submission, over 60% within 24 hours and over 75% within 48 hours. Registration guide
How do patients opt out of texts?
Spruce handles it for you. When your practice starts a text conversation, Spruce automatically identifies your practice and includes opt-out instructions. If a patient replies STOP, they're unsubscribed automatically. Help Center
How much does HIPAA-compliant texting cost?
Spruce plans start at $24 per user, per month, with 2-way SMS texting and secure app-based messaging included. The Communicator plan ($49 per user, per month) adds bulk messaging and missed-call text-back. If you text, carriers charge a one-time $19.50 registration fee and a small monthly campaign fee, which Spruce passes through at cost. See plans and pricing.
Can I use Google Voice to text patients?
Not for business texting. US carriers require business numbers to complete A2P 10DLC brand and campaign registration, and Google Voice offers no way to register, even on paid Workspace plans. Its Acceptable Use Policy also prohibits automated messaging, so appointment reminders, auto-replies and bulk texts aren't an option. Texts from unregistered numbers risk being filtered or blocked by carriers, and accounts that break the policy can be suspended. Spruce is built for compliant, automated business messaging from day one, and our support team guides you through registration. Spruce vs Google Voice
Related guides
Help Center
From the blog
Explore Spruce
Reply faster. Reach more patients. Stay compliant.
Bring 2-way SMS texting to your practice with Spruce.
- Text from your practice number
- Every text in one shared team inbox
- BAA included from day one
14-day trial. No credit card required. Cancel anytime.