About Spruce fax

Spruce fax is a HIPAA-compliant eFax service that lets you both send and receive faxes. You do not need a physical fax machine to use Spruce fax, but you can send faxes to and receive faxes from physical fax machines fax numbers, just as if you were using one. You can, of course, also use Spruce fax to send faxes to and receive faxes from other eFax services. 

Acquiring a Spruce fax number

There are two ways to get a Spruce fax number:

  • Transfer an existing fax number into Spruce ("porting")
  • Get a new fax number for use on Spruce

You can also have multiple fax numbers in your organization on Spruce; just ask us in the in-app Support conversation to discuss details.

Transfer your existing fax number into Spruce ("porting")

When you subscribe to a Spruce plan, you can then transfer your existing fax number into Spruce. To initiate this, click here, or you can navigate to your Spruce settings, then click on "Fax", then "Add a Fax Number", then "Transfer an Existing Number". To complete this form, you will need a copy of your most recent fax bill. This process takes about two weeks. Your fax number will remain fully functional with your current carrier during this time.

Once you port your fax number into Spruce, it will no longer be compatible with a physical machine; you will only be able to receive and send faxes through Spruce. If your fax number previously functioned as a phone number and a fax number, it will lose phone capabilities (i.e., calling and texting) once it has transferred to Spruce as a fax number, and it will only function as a fax number in Spruce.

To learn more about porting your phone number to Spruce see this help article on phone number porting.

Get a new fax number with Spruce

To provision a new fax number, click here, or you can navigate to your Settings in the Spruce app, select Fax, and click the "Create Spruce Fax Number" button. The system will ask you for your preferred area code, and a new fax number will be generated. We do not provide custom fax numbers at this time.

Fax is available on every Spruce plan at no additional cost and it's unlimited inbound and outbound faxing. 

Watch a video to see how to get a fax number on Spruce.

Receiving a fax

Faxes sent to your Spruce fax number will arrive as PDF attachments in your Spruce inbox. Every new fax will appear as a new conversation in your inbox, even if the fax is from a number that has sent you a fax previously. This is done intentionally, as most healthcare providers receive faxes from the same fax number but regarding different patients. Having every fax appear as a new conversation will make it easy for you to attach/file the appropriate documents to the correct patient.

File a specific inbound fax to a contact by using the "regarding" feature:

  • Click into the fax conversation when it appears in your inbox.
  • Select the "i" icon in the upper right-hand corner.
  • Scroll down until you see a field for "Regarding."
  • Click into the "add contact" field.
  • Select the relevant patient or other contact from your contact book.

To revisit this fax conversation, find the patient in your contact book at any time, click into their contact, and toggle over to "Conversations" listed right next to "Details." You'll be able to see any notes, calls, messages, and faxes associated with this patient.

Watch a video on sending and receiving faxes in Spruce.

Sending a fax

Every outbound fax will create a new conversation, allowing you to associate each fax with the most relevant contact. 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. Spruce fax automatically generates a cover page for your fax using any text you write in the message field before you send your fax.

Sending a fax from your Inbox

From the Inbox, select the Blue icon with pencil and paper if on web (mobile select the + button), select Fax and enter the "to: phone number or contact" and confirm the "from:" fax number (if you have multiple fax numbers). You also have the option to indicate which Contact this fax is regarding, if you want this fax to show up under a contact's conversations. Additionally, after sending a fax you can provide a subject for the fax to identify what it is about, which can help to prevent confusion when you have multiple faxes associated with a contact. To do this, after sending your fax, select the [i] and add a subject in the subject field.

If on your Web browser version of Spruce,  open up conversation details ("i" in the upper left corner), go to the contact (name or fax number) under Conversations Between and click on the fax icon to the right of the fax number.  See this demo video

If on your mobile (android or iOS), click on "Send Another Fax" button from within the conversation. 

Sending a fax from Contacts tab

In your Contacts, find and open the Contact that you wish to fax. If they have a fax number stored, and they are listed as a "professional" contact (i.e., not a "patient"), you will see a blue fax icon on their Contact card. Click this icon, and a new fax message will open, after which you can follow the same instructions as above to finish sending your fax.

Fax cover sheet information

The Spruce fax cover sheet will automatically display a from section that will contain your Practice Name, as listed in your Spruce account, the name of the user who sent the message, the user's default phone number and the fax number the fax was sent from. 

You can also add a note or message to the cover sheet by adding text copy in the compose area before sending the fax. There will also be a footer saying Powered by Spruce Health with our information. 
We can disable the cover sheet from showing the user's Display Name and then it will only show your practice name. We can also turn off the phone number from being displayed. We can also remove the Spruce branded messaging. We cannot update with a custom logo. Please message Team Spruce to update this.

Organizing Faxes in Your Inbox

Many customers prefer to have all fax communication appear in a separate filter within their Inbox so that it does not cause direct patient communication to be missed. If this would be helpful for your organization please follow these steps:

  • Navigate to Settings/Teams and create a team called Fax (the name of the team can be whatever you choose). Add any teammates who should monitor incoming faxes. All members of the Fax Team will automatically see a new filter titled “Assigned to Team Fax” in their Inbox. They can hover over this, select the three vertical dots, and edit the filter to rename it if desired (for example shortening the name to just Fax).
  • Navigate to Settings/Fax and choose your fax number, then edit “Conversation Membership.”
  • Change the “owner” of the number to the team you created.
  • In the “additional internal members” field  you can leave the organization listed if everyone should have access to faxes, if this should be limited to the team only you can remove the organization from this field.

This video demonstrates the above steps.

Media attachment options

  • Text: Any text typed into the message-compose bar while creating a fax will be included in a fax cover sheet.
  • PDF: Any attached PDF file will be converted to black and white and included as typical fax pages 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 single fax page that contains a QR code to download and view the video. Don't worry: we will not send every image frame of the video as a separate fax page. ;)

PDF guidelines

For best results when faxing PDF documents:

  • Keep PDFs black and white. Any color will be converted to black or white (not gray), so recipients may not see what you expect them 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. Many Spruce users have reported good results with Scanbot, which is available for free on iOS and Android. When creating your PDF in Scanbot, be sure to convert it to black and white. Once you’ve created the PDF, select Share, then Copy. You'll then be able to paste the PDF into the compose bar in Spruce, and send your fax.

Blocking Fax Numbers

To block a fax number, click on the fax number or contact to open their contact card. Then, click on the 3 vertical dots next to the fax number that you want to block and select “Block Fax Number”. Once it’s blocked, it will say “Blocked” in red text next to the number. 

You can also manage your list of blocked fax numbers from your Spruce settings, under “Fax”, then “Blocked Fax Numbers”.

Trouble sending or receiving faxes 

Please contact the Spruce Support team in your Spruce app if you are experiencing an error while trying to send a fax. If another person is reporting that they have sent you a fax but you never received it, please share their fax number and the date and time of the attempted fax. With this information, we will report the failure to our fax carrier. Please do the same for any faxes you have sent that were not received by your intended recipients.

Maintaining HIPAA compliance 

All users of Spruce agree to our Terms of Service, which include our HIPAA Business Associate Agreement (BAA), as applicable. Importantly, Spruce stores your fax contacts and transmission logs, as well as digital copies of all of your incoming and outgoing faxes, identically to how we store all other medical data. This means that your fax information is protected by the same technical, administrative, and physical safeguards that HIPAA demands and that we use regularly throughout our entire system.

For more detail on using Spruce fax while maintaining regulatory compliance, please see our white paper on Using Spruce in a HIPAA-Compliant Way.

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