Spruce Fax


Introduction to Spruce HIPAA-Compliant fax

By using Spruce electronic fax, you can send and receive faxes from the same place you exchange messages, make calls, and listen to voicemails for your business. Spruce fax works much like adding an attachment to a message; in fact, you can fax image files and even video links in addition to standard PDF documents. Additionally, Spruce fax automatically generates a cover page for your fax using any text you write in the message field before you send. To get started, we can port your existing fax number to Spruce, or we can provision a new fax number with your preferred area code.

  • To port a fax number, please contact the Spruce Support team. Include the fax number that you want to port and a copy of your most recent bill. This process takes about one week. Your fax number will remain fully functional during this time. 
  • To provision a new fax number, contact the Spruce Support team and include your preferred area code. 

Fax is available on every Spruce plan ( see plans here).

Please note, because Spruce supports electronic faxing, there is no fax machine required nor can it be used with a physical fax machine.

Receiving a fax

Faxes sent to your Spruce fax number will arrive as PDF attachments in your Spruce inbox. Similar to messages, phone calls, and voicemails, each fax will populate in the Standard Conversation of the sender. Please note, because the sender of a fax is often a facility or another practice, this means your faxes will be located in the Standard Conversation associated with that entity, not necessarily the patient that the fax is about.

Sending a fax

To send a fax, there must be a Standard Conversation created with a fax number on file for the recipient. 

  • If a Standard Conversation does not exist already, select the Plus + Icon, select Fax, and input the recipient's fax number. Optionally, you can include the recipient's first and last name and company name. Then select Create Conversation 
  • If the recipient has a Standard Conversation, but no fax number on file, open the conversation and select the Person Icon in the top right corner. Edit the Profile to include a fax number.

To send a fax:

  1. Open the recipient's Standard Conversation.
  2. In the Compose Bar, select Fax.
  3. Compose your message (this text will go on the fax Cover Page).
  4. Add your attachments, including PDFs, image files, and more 
  5. Select Send

Media options

  • Text: Any text typed in the message will be included in a fax cover sheet.
  • PDFs: Any attached PDF will be converted to black and white and will be included after the cover sheet. For best results, choose PDFs that are already black and white and that don’t contain any large images. 
  • Images: Attached images will be converted to black and white and included in the fax. This can be used to send photos of single-page documents, such as a signature page, as part of your fax. When you include image files, the fax will also include a QR code to download the full-resolution, color image.
  • Video: You can include a video in your fax! The recipient will get a QR code to download and view the video.

PDF guidelines

  • Keep PDFs black and white. Any color will be converted to black or white (not gray), so recipients may not see what you expect then to if you include any color images.
  • Use standard U.S. Letter sized pages (8.5" x 11"). Any non-standard page size might be rejected by the recipient’s fax machine.
  • Keep it brief. Some fax machines are configured to reject faxes that exceed a certain number of pages. You're usually safe under 30 pages, but if you plan to send a large fax, check with the recipient to see if they have a page limit.

There are several mobile apps that can create PDFs using your phone's camera if you don’t have a scanner in the office. We recommend Scanbot, which is available for free on iOS and Android. When creating the PDF, be sure to convert it to black and white. Once you’ve created the PDF, select Share, then Copy. Then you'll be able to paste the PDF into the compose bar in Spruce. 

Maintaining HIPAA compliance 

When you check out for a paid Spruce plan and sign a Business Associate Agreement (BAA) with Spruce, any communication that occurs entirely on Spruce (e.g., app-to-app messaging with providers or patients, telemedicine within a secure messaging thread) is inherently secure, encrypted, and compliant with the technical requirements of HIPAA.

While fax is a form of communication that goes outside the Spruce app, you can still maintain HIPAA compliance with fax as long as (1) the patient is made aware that standard messaging has security vulnerabilities and (2) you offer a secure communication alternative (like secure messaging). Please take a look at our White Paper on HIPAA compliance to learn more. 

At the end of the white paper, you will find a template that you can use with patients in the office to document their written consent for using Standard Conversations, which include fax, to communicate with your practice.

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