1. Review Consent First 

• Always confirm that the patient has provided the correct opt-in consent before sending any messages.
• Remember: transactional and marketing messages require separate and distinct consents. Be sure the patient’s consent status is correctly documented in their record. 
• Check out our article on Managing Consent to Text Messaging for more information. 

2. Keep Messages Necessary and Concise

• Limit texts to what is truly necessary—short, clear updates are best.
• Avoid sending unnecessary multiple back-to-back texts that may overwhelm patients or increase the risk of being reported as spam. 
• While messages over 160 characters are allowed, they will be split into multiple segments, which may affect readability and costs.
• Do not mix transactional and marketing messages in the same message if the patient has not opted in to both transactional and marketing messages.

3. Avoid Sensitive Health Information

• Texting is inherently insecure. Remind patients not to include protected health information (PHI) or discuss their health status via text.
• Clinic messages should include only the minimal necessary details (e.g., “Your appointment is tomorrow at 10 AM”).

4.  Be Cautious with Frequency & Timing

• Too many messages may frustrate patients and increase the likelihood of opt-outs.
• Marketing texts are far more likely to be flagged as spam. Excessive or unwanted marketing communications can even result in carriers delisting or blocking your clinic’s unique texting number.
• Respect timing for marketing messages: Marketing texts should only be sent during standard business hours (8 AM–9 PM in the recipient’s local time zone). Sending promotional content outside these hours increases the risk of complaints, opt-outs, or spam reports.