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Send and receive SMS

SMS lives in the Inbox → Messages tab. Send one-off texts to any patient, set up automated appointment reminders, and respond to inbound messages from one shared team thread. Local US numbers require A2P 10DLC; toll-free numbers work immediately after verification.

Updated May 20, 20261 min read

Texting is how most patients prefer to communicate. FrontDesk turns every phone number into a 2-way SMS channel that your whole team can see and respond to.

Send a text

  1. Open Inbox → Messages.
  2. Click + New Message.
  3. Pick a recipient — search by patient name or paste a phone number.
  4. Pick a from number (if you have multiple).
  5. Type your message and hit Send.

Messages send within seconds. You'll see delivery status (sent, delivered, failed) update in the thread.

Reply to an inbound text

When a patient texts your practice number, a thread appears in Inbox → Messages with an unread badge. Click the thread and type a reply — same as any messaging app. All teammates see the same thread, so handoffs are clean.

Automated appointment reminders

In Settings → Messaging → Reminders:

  • 24-hour reminder — sent the day before
  • 1-hour reminder — sent the morning of (or 1 hour before)
  • Confirmation request — patient texts back YES to confirm or RESCHEDULE to change
  • No-show follow-up — texts the patient 15 minutes after missed appointment

Reminder templates support merge fields like {patient_name}, {provider}, {date}, {time}, {location_name}, {location_address}.

A2P 10DLC for local numbers

US carriers require business SMS on local (10-digit long code) numbers to go through A2P 10DLC registration. Without it:

  • Messages may be silently blocked
  • Heavy throttling (~1 message/second/number max)
  • Some carriers (T-Mobile especially) block hard

Toll-free numbers don't need 10DLC — they have their own free verification process (~3–5 days).

Register for A2P — takes 5 minutes to submit, 1–7 days for carrier approval.

What's next

Frequently asked questions

Where do inbound texts show up?
In the Inbox → Messages tab. Threads are per-phone-number-pair (your practice number ↔ patient number), and all team members see the same threads. New unread messages appear with a badge on the Inbox nav item.
Can my AI respond to texts automatically?
Inbound AI texting is in beta. Today inbound SMS routes to the Inbox for a human to reply. Outbound automated reminders (24h before appointment, 1h before) are fully automatic.
Why do my local numbers need extra setup for SMS?
US carriers require A2P 10DLC registration for all business SMS on local numbers — without it, messages may be blocked or fall back to per-recipient throttling. See A2P registration for the process.
Can patients text back to the same number that calls them?
Yes. Voice and SMS share the number. A patient who gets a reminder text from (415) 555-0123 can call that number and reach your AI receptionist.

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