Spruce is built to function optimally for businesses operating in the United States. While the app is available for download in other regions, we do not officially support businesses based outside of the U.S. If you have teammates abroad or are traveling internationally, you may still use Spruce.
International teammates on Spruce
If you have staff members outside the U.S., they may be able to use Spruce, but there are limitations. For more details, please review this help article.
International calling on Spruce
Spruce supports inbound and limited outbound international calling.
Inbound International Calls
- Incoming calls from international numbers function like domestic calls on Spruce. You can receive and manage these calls normally.
Outbound International Calls
Outbound international calling is limited to certain regions within the North American Numbering Plan (NANP)—countries that use 10-digit phone numbers with the +1 country code. The supported regions are:
- United States (+1)
- Canada (+1)
- Puerto Rico (+1-787, +1-939)
- Jamaica (+1-876)
- Trinidad and Tobago (+1-868)
- Turks and Caicos Islands (+1-649)
- U.S. Virgin Islands (+1-340)
At this time, Spruce does not support outbound calls to countries outside of this list.
Using Spruce in Canada
While Spruce is available for download in Canada, we do not officially support businesses based in Canada due to several limitations:
- Calling Restrictions: Calls made through Spruce use a U.S.-based number, which may result in long-distance charges unless you enable Softphones (internet-based calling).
- Caller ID: This is not supported with Canadian numbers.
- SMS Limitations: Canadian regulations require a Provincial or Federal Corporation/Registry ID Number for outbound SMS registration, and therefore, you cannot send outbound SMS if you use Spruce.
- Security & Compliance: While we follow HIPAA guidelines and have completed a SOC 2 Type II audit, we do not have policies specific to Canadian privacy laws.
Due to these challenges, we do not recommend using Spruce for Canada-based businesses.
Using Spruce While Traveling Internationally
If you are traveling internationally with a U.S. mobile phone, Spruce will continue to function as long as you have a stable internet connection or cellular coverage. You can:
- Make and receive calls via the Spruce app (subject to international roaming or Wi-Fi availability).
- Manage secure messages, SMS texts, and voicemails from anywhere.
Patient App Requirements
Patients who wish to download and use the Spruce app for secure messaging and video calls must meet the following requirements:
- Have a 10-digit phone number.
- Use a mobile device connected to the U.S. or Canadian app store (available for both iPhone and Android).