> ## Documentation Index
> Fetch the complete documentation index at: https://docs.routiq.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# SMS Channel

> Patients text your clinic — Robyn replies. Two-way SMS for bookings, confirmations, recall sequences, and casual questions.

<Info>
  **Why this matters.** SMS is the channel patients actually answer.
  Average open rate is over 95% within 3 minutes — vs. \~20% for email.
  For appointment confirmations, recall sequences, and quick "running
  late" messages, nothing else comes close.
</Info>

## How it works

Robyn's SMS works two ways:

* **Inbound** — patients text your AI number, Robyn replies in the same conversation thread (bookings, reschedules, questions, escalations)
* **Outbound** — Robyn sends reminders, confirmations, recall messages, waitlist callbacks, invoice chases, all from the same number

Same number for both. Patients see a single, continuous SMS thread with the clinic.

## How Robyn handles SMS

<CardGroup cols={2}>
  <Card title="Inbound booking request" icon="comment-dots">
    "Can I get an appointment Tuesday?" → Robyn checks availability, suggests slots, books on confirmation.
  </Card>

  <Card title="Outbound confirmation reply" icon="check-double">
    Robyn sends a confirmation; patient replies "yes" / "no" / "reschedule" — Robyn parses and acts.
  </Card>

  <Card title="STOP / opt-out" icon="ban">
    Patient texts STOP — Robyn acknowledges, marks the patient as opted out of all outbound, no further messages sent.
  </Card>

  <Card title="Question outside scope" icon="circle-question">
    "Can I take ibuprofen with my treatment?" → Robyn doesn't answer clinical questions; escalates to the team.
  </Card>
</CardGroup>

## What your patient sees

> **Robyn (SMS):** Hi Sarah, this is Robyn from Bondi Physio. Just confirming your appointment Friday 9 May at 2:00pm with Dr Lin. Reply YES to confirm, NO to cancel, or RESCHEDULE if you need a different time.
>
> **Patient:** Yes
>
> **Robyn:** Great — see you Friday. If anything changes, just reply to this thread.

## Setup

<Steps>
  <Step title="Use your AI number">
    Your Routiq AI number (provisioned during [Calls Channel](/channels/calls) setup) is SMS-enabled by default in regions that support 2-way SMS — AU, NZ, UK, US, IE, CA.

    No second number to manage.
  </Step>

  <Step title="Confirm regional capability">
    SMS regulations vary by region. Routiq handles the compliance work, but here's what you should know:

    | Region                | 2-way SMS         | Notes                                                             |
    | --------------------- | ----------------- | ----------------------------------------------------------------- |
    | AU / NZ               | ✅ Full support    | Outbound and inbound                                              |
    | UK                    | ✅ Full support    | —                                                                 |
    | US / CA               | ✅ Full support    | A2P 10DLC registration handled by Routiq                          |
    | IE                    | ✅ Full support    | —                                                                 |
    | NZ outbound to mobile | ⚠️ Sender-ID only | NZ has carrier limits on alphanumeric sender; uses your AI number |

    See your **Settings** → **Account Setup** → **SMS** page for the active configuration in your region.
  </Step>

  <Step title="Customise message templates">
    **Settings** → **Outbound** → **SMS Templates** for the default templates Robyn uses for:

    * Appointment confirmations
    * Reminders (multiple cadences)
    * Recall sequences
    * Waitlist offers
    * Invoice chases

    Each template supports patient-specific variables: `{first_name}`, `{appointment_time}`, `{practitioner}`, `{location}`, `{appointment_type}`.
  </Step>

  <Step title="Set opt-out language and footer">
    Per most regions' regulations, outbound marketing-style SMS must include opt-out instructions. Defaults:

    * **AU / NZ:** "Reply STOP to unsubscribe"
    * **UK:** "Reply STOP to opt out"
    * **US / CA:** "Reply STOP to unsubscribe. Msg\&data rates may apply."

    Customisable per template.
  </Step>
</Steps>

## Phone-number formats Robyn accepts

When patients text in or you import a contact list, Robyn normalises numbers automatically:

| Region | Local format examples         | E.164 format    |
| ------ | ----------------------------- | --------------- |
| AU     | `0412 345 678`, `412 345 678` | `+61412345678`  |
| NZ     | `021 123 4567`                | `+6421 1234567` |
| UK     | `07700 900 123`               | `+447700900123` |
| US     | `(415) 555-0123`              | `+14155550123`  |

Robyn won't message the same number twice in a single conversation (deduplication on E.164).

## Costs

Outbound SMS is metered per segment (160 chars / 70 chars for unicode). Routiq's dashboard shows usage and cost in real time — **Outbound** → **Usage**. Routiq's messaging is charged at 10c AUD per message, in addition to carrier pass-through costs, which vary by region; AU/NZ averages around AUD $0.04 / segment, UK around £0.025, US around USD $0.01.

## Common questions

<AccordionGroup>
  <Accordion title="Can patients reply to outbound messages?">
    Yes. Every outbound SMS is sent from the same AI number, and replies land in the same conversation thread. Robyn handles the reply automatically (confirmation parsing, escalation, etc.).
  </Accordion>

  <Accordion title="What about MMS or images?">
    Inbound MMS is captured and saved to the conversation, but Robyn doesn't reason over images today. Outbound is text-only.
  </Accordion>

  <Accordion title="What if a patient sends a clinical question via SMS?">
    Robyn detects clinical-territory messages ("is this normal", "should I take X", symptom descriptions) and escalates to your team rather than answering.
  </Accordion>

  <Accordion title="STOP — does it apply to all outbound, or just this campaign?">
    All outbound. STOP marks the patient as opted out across reminders, recalls, confirmations, and waitlist offers. They can still text in (inbound is unaffected).
  </Accordion>

  <Accordion title="Will patients see the SMS thread on their phone as one continuous conversation?">
    Yes — every message Robyn sends comes from the same AI number, so the patient sees one thread on their phone over weeks and months.
  </Accordion>
</AccordionGroup>

## Next

<CardGroup cols={2}>
  <Card title="Appointment reminders" icon="bell" href="/outbound/appointment-reminders">
    Set up automated SMS reminders before appointments.
  </Card>

  <Card title="Patient follow-ups" icon="comment-medical" href="/outbound/patient-follow-ups">
    Post-appointment recall sequences via SMS.
  </Card>
</CardGroup>