Inviting Patients to Spruce


Introduction to inviting patients

Spruce offers many communication channels including phone, fax, SMS text, email, video, and secure messaging. Although some channels don't require the patient to download the Spruce app, those that do include secure messaging, video calling, Spruce Visits (clinical questionnaires), and payments. The patient is required to create a Spruce patient account either on the Spruce mobile app or on their computer. They also need to be connected to your practice. 

You may invite a specific contact or a group of contacts right from the platform using a link created just for your practice (Spruce Link). Once your patient has created their account online or joined via their mobile phone, you can start exchanging private, secure messages with them. Please note that only standard phone calls, SMS texting, fax, and email may be exchanged without your patient having to download the Spruce app.

Inviting a patient to Spruce

Create and send your invite message

We recommend inviting your patients to join you on Spruce through the platform

From your inbox, tap the pencil icon when on the web / + icon on mobile, select Invite Patient to Spruce, enter your patients name or phone number to search to identify if the individual already exists in your Contact list. If they are not in there, click Invite New Patient. Then enter their information in and you can even customize the message they will receive along with your Spruce Link, then select Invite to send. Please note this invitation will be sent via SMS text message only if you enter include a phone number. 

The benefit of first searching for a contact is that you can see if that patient already exists in your address book and if it does, you can see that and send them the invitation using their pre-populated information (email and/or phone). Alternatively, you may also see at-a-glance if the patient is already on Spruce and you may begin messaging them securely without having to send an(other) invite.

The beauty of sending an invitation through Spruce is that you'll be able to track the state of the invitation. Once the invite is sent, you'll see on the Contact Card that there's an invitation pending. If the invite were just sent as an SMS within Spruce with your Spruce Link, there would be no way to track whether the invitation was sent (or not), seen, or acted upon. 

Of note: when you send an invite to your patient, it's important that the patient understands who the message is from, what they are supposed to do, and what they will get as a result. That's why creating a custom message with your invite is essential. Here's an example of a custom message to get you started:

“Hello – this is Dr. Brown from Brown Clinic. I’d like to invite you to sign up for the Spruce app to communicate with us about your medical care. With Spruce, you can securely text, email, send pictures, and even video chat! Follow this link to download the Spruce app and get connected”

Another important benefit of inviting patients through Spruce is that you can track all of your patients that have been invited but have not yet accepted the invitation. It's simple to create a list that shows you those contacts and you may select them and invite them (again). You may also create a list of those patients who have not yet been invited, and send them an invite to join you on Spruce.

Patient Experience

When a patient receives your invite, they'll go through the following steps:

If on a mobile device (available on android and iOS devices) this is their instructions: 

  1. Click the Spruce Link and this will open up a mobile browser showing the Organization Profile.
  2. At the bottom of the page click on, "Connect" to be redirected to their phone's app store.   
  3. Download the Spruce app from the app store.
  4. Open the Spruce app and select Continue to confirm they are connecting with the correct practice.
  5. Select Create a new account.
  6. Set up a patient account with their personal information.

If on a computer web browser: 

  1. Click the Spruce Link and this will open up a browser showing the Organization Profile (which you can update in your Settings).
  2. At the top of the page they'll click on, "Connect with [Clinic Name]". 
  3. A new window will open and patient will click "Get Started". 
  4. Create the patient account with phone number for verification purposes and email.

Spruce Links make it easy for your patients to connect directly with your practice. Each Spruce Link is a unique URL that follows this format: or

When a patient clicks on your Spruce Link or enters the URL in their browser, they’ll see your Organization Profile. You can customize what they see when they land on your profile from within your Spruce settings. They may then select Connect and will be directed to the app store or web-based login. When the patient creates their account this way (rather than directly from the app store), they will be automatically connected to your practice upon setup, and a new secure patient conversation will appear in your Spruce inbox. 

Creating your Spruce Link

You can create a Spruce Link from your Spruce settings, under the section titled "Secure Messaging". There, you'll have the ability to customize the link, label it, configure the default members, and even configure conversation and contact tags you'd like associated with your link(s). The QR code that is automatically generated when you create your link is just another way to share the same information.

Managing Ownership

In addition to using your Spruce Link to invite new patients to download the app, you can also use it to initiate new secure conversations with patients. When you send an SMS text message to a patient, it will come from your Spruce number, but when you send secure app-to-app messages, it will come from a Spruce Link. You'll notice when initiating a new secure message, that the "From" field will include your Spruce Link.

You can determine who the owner is for every Spruce Link that you create. This is most helpful if you have a team on Spruce. If someone is an owner, this means that they will be able to see all communication sent to and from the Spruce Link. They'll be able to initiate secure messages and receive them. Non-owners will not have access to correspondence regarding this Spruce Link. 

To manage owners, visit your settings, and select "Secure Messaging," select any Spruce Link and add or change the owner under the "Owned By" section on mobile or "Owner" on web.

Managing Additional Members

In addition to adding an owner, you can also add additional members to Spruce Links. Additional members can also see incoming communication to the Spruce Link and can initiate correspondence using the Link. Non-members will not have access to any conversations where the Spruce Link is involved.

To manage members, visit your settings, and select "Secure Messaging," select any Spruce Link and add or change the members under "Additional Members" on mobile or "Additional Internal Members" on web.

Please note that you cannot remove a member or owner from a specific patient conversation they're already in. You can, however, decide to change the owner and add additional members at any time. New members will have access to existing and new conversations.

Adding Contact and Conversation Tags

You'll notice that you also have the option to add contact and conversation tags. You can learn more about contact and conversation tags here. To summarize, any conversation tags you add to the Spruce Link will get applied to every patient conversation initiated with that Spruce Link. They'll also get applied when someone reaches out to that Spruce Link. If you remove the tag, the tag will no longer be applied to these conversations.

Adding a contact tag will add that tag to any contacts that are created by interacting with that Spruce Link.

Tagging is helpful when you'd like to categorize patients or indicate that particular conversations belong to a specific provider. You can also create new inbox filters that show you conversations with a specific tag. Learn more about conversation filters here

To add tags to any Spruce Link, visit your settings, and select "Secure Messaging." Select any Spruce Link and  scroll down until you "Apply Tags." Apply any tags to the conversation or contact level. 

Spruce Link Auto-Assignment

This is mostly relevant if you're on a team. If you choose a specific teammate or Team to be the owner of a Spruce Link, you'll also have the option of turning on "Auto-Assign." This means that anytime someone sends a message to that Spruce Link, the conversation will automatically get assigned to the owner of that Spruce Link. The conversation will fall in their "Mine" inbox/filter if the owner is an individual and the "Assigned to X Team" if the owner is a team. These conversations will not land in the main inbox. This is helpful if only particular teammates need to see incoming communication to that Spruce Link.

To turn on auto-assignment visit your settings, and select "Secure Messaging." Select any Spruce Link and click into the owner if you're on mobile. Be sure to select "Edit" if you're on web. Toggle on "Auto-Assign Conversation" on web under the owner. Blue indicates that it is on and active. Select the owner on mobile and then toggle on "Auto-Assign Conversations."

Distributing your Spruce Link

Spruce Links are an effective way to drive heavier adoption of the Spruce app amongst your patients. Here are some examples of how other providers have shared their Spruce Links with patients, so that they'll use it to download the app:

  • Email marketing: Advertise that your practice offers secure messaging via an email newsletter.
  • New patient onboarding: Incorporate downloading Spruce into your new patient onboarding by sharing the Spruce Link.
  • In-office displays: Display the Spruce Link in-office on a flyer or business card at your front desk.
  • Website: Differentiate your practice on your website by advertising that you offer secure messaging through Spruce. 
  • Advertising: Use Spruce Links to track referral sources for inbound patients coming from online or print ads.

Patient identity verification with Spruce Links

When you manually invite a patient to a Spruce secure conversation, you provide us with the patient’s mobile number or email address, and we verify one of those points of information before pairing a patient with your practice.

When you use Spruce Links, anyone with access to that link can be paired with your practice. During the account creation process, they enter their own name and mobile number (and we confirm that they own that mobile number with two-factor authentication). We pair the patient with your practice based on the fact that they have access to the link and not any additional contact details that you have provided to us.

As such, when using Spruce links, it is the responsibility of your practice to verify the patient’s identity before divulging PHI. We recommend the following:

  • Confirm that the patient’s phone number and email address listed in the Spruce secure conversation matches the patient’s phone number and email address in your records.
  • If the phone number or email address don’t match the information in your records, contact the patient through a known method of communication to confirm the alternate contact details and that they have created an account on Spruce via your Spruce Link.

Using QR Codes

Your patients can utilize a QR code to get connected with your practice. For any Spruce Link you generate, a QR code will automatically be available. You can find it in your settings, under "Secure Messaging", then by clicking on the Spruce Link for the QR code you want to view. If a patient utilizes one of your QR codes, they will be taken through the same patient onboarding flow that clicking on the Spruce Link initiates.


How do I help a patient who is having trouble with creating an account on Spruce?

Many of our providers choose to communicate with their patients via secure messaging by inviting them to download the Spruce app. In the vast majority of cases, patients are able to accept invitations and get set up on Spruce without any issues!

Occasionally, your patients may encounter some issues in accepting your invite or creating an account on Spruce. Below, we share some tips on how you can help your patients troubleshoot the process of connecting with you on Spruce. You can also direct patients to our help center article written specifically for patients, which has successfully helped many patients self-identify their issues.

I sent my patient an invitation, they downloaded the app, but now they can't get connected with my practice.

If this is the case and your patient is stuck on the 'I'm a Patient' screen, please ask your patient to:

  1. Delete/uninstall the Spruce app on their phone.
  2. Follow the invite process again by tapping on the link in their SMS, tapping the button in their email, or entering your Spruce link into their browser.

My patient already has an account on Spruce but is now having trouble logging in.

This can occur for a number of reasons. You should determine which reason and then follow the instructions below.

My patient can't remember their password: If your patient has forgotten their password, please ask them to reset their password at Neither you nor Spruce can reset their password on their behalf.

My patient can no longer receive text messages to receive a verification code: If your patient can no longer receive text messages to the number associated with their Spruce account, they may have issues with accessing their account if prompted for a 6-digit verification code. If this is the case, we can update the phone number associated with their account. To do so, please ask your patient to email us at with the following information:

  • Their full name
  • A photograph of their face alongside their photo ID (driver's license, passport, or government issued ID)
  • Their new mobile phone number

Note: We collect this information to verify their identity and protect the security of their account. We do not share this information.

My patient can't remember the email they used to sign up to Spruce: If your patient can't remember the email address they used to sign up to Spruce or are attempting to create a new account but are getting an error, you can remind them of the email address they used by navigating to your Spruce inbox, searching for the patient by name, opening their Secure Conversation, and navigating to "Contact Info". There you will see what email address they used to create their account.

My patient wants to use Spruce but does not have a smartphone.

No problem! Spruce is accessible on any browser. The patient will click on your Spruce Link or paste it into the browser on their computer to create their account associated with your practice. 

Patients will need a phone that accepts SMS text as we use that to verify their identity. Unfortunately you will be unable to conduct secure messaging or video calls with those that don't have a method to receive SMS text codes. However, you can easily communicate with them via standard messaging (SMS and phone calls.)

My patient downloaded Spruce from the app store and now the invitation I sent them doesn't work.

It is important for patients to download the Spruce app by following the instructions within the invitation you sent them, and not download it directly from the app store. If your patient downloaded the Spruce app without following the invite process, please ask your patient to:

  1. Delete/uninstall the Spruce app on their phone.
  2. Follow the invite process again by tapping on the link you provided or entering it into their browser.

Still Having Trouble?

If your patient is still having trouble please ask your patient to view our patient support help article here.  

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