All-in-one healthcare communication

Whether it's upgrading your patient experience or modernizing your communication toolkit, see why Spruce is the leading platform for HIPAA-compliant healthcare communication.

Get Started for Free

Get Started for Free

14-day trial. No credit card required. Cancel anytime.

#1 platform for HIPAA-
compliant communication

10+

YEARS IN
BUSINESS

25,000

HEALTHCARE
PROVIDERS

5M+

PATIENT
ACCOUNTS

500,000+

DAILY HEALTHCARE
INTERACTIONS

Get Spruce NOW!

I could not be happier, my clients could not be happier, and I simply could not give Spruce a higher endorsement!

Must have!

It’s SO incredibly helpful to be able to just message your doctor when you have a question, need a refill, need an appt, etc.

This is perfect!

I love spruce because I can text or call patients when I’m unable to call them from our office phone system, like when I am on call for my group over evenings and weekends.

Most Fantastic Client Support

I feel like I'm the most important person in the world! Their professionalism, prompt responses, but even more meaningful to me is I feel cared about. WOW.

Saves Us Time!

Spruce is built for doctors’ offices. It does exactly what we want, and it just works. It saves us time and allowed us to deliver a better product and communicate better with our patients.

Jonathan Feistmann MD,  NYC Retina

Solves Our High Call Volume

Our staff couldn't support our call volume. Spruce has given us the ability to communicate more efficiently with patients, even with a small staff and large call volume.

Kaela Thurman NP,  Hometown Health Center

Spruce Prioritizes Confidentiality

My clients' privacy is very important. I want to offer a safe and protected way of communicating with me. Spruce came highly recommended and doesn't disappoint!

Holly Spotts, Psychologist,
Full Cup Wellness

Spruce Grows With Us

We can handle our growing client base much more effectively. Spruce has allowed us to grow without sacrificing the quality of care we provide.

Carmen Mellone Director of Admin Ops,  Life Insight

Spruce Has Been A Game Changer!

Spruce gives me the ease of unified patient communication and follow-up. It has been a game-changer for my office.

Dr. Kira Stein, MD, APC, Clinical Psychiatrist

Clients Feel Safe And Secure

I want my clients to know that I’m on their side and I will fight for their confidentiality to the best of my ability. Spruce allows them to feel safe and secure.

Dr. Abi Weissman, Psy.D., Waves

A Seamless Transition

We had never done any kind of teletherapy before, but we needed a telehealth platform immediately. Spruce helped make that a really seamless transition.

Landon Dickeson, MS, LPC., Ranch Hands Rescue

Communication

All your communication channels, all in one place. Spruce is designed for easy HIPAA compliance .

Secure Messaging

Send messages, files, audio notes, and more

Phone

Includes 2-way SMS texting and voicemail transcription

Video

Offer virtual visits from anywhere

E-Fax

Send and receive e-faxes

Team Messaging

Individual and group messaging with task assignment

Notes

Privately coordinate with teammates in patient conversations

Modern Care

Best in class telemedicine from your phone, desktop or anywhere in between

Video Visits

Offer care from anywhere with secure video visits.

Clinical Questionnaires

Screen patients in advance with our selection of clinical questionnaires.

Digital Payments

Get paid faster with in-app digital payments.

Workflow Automation

Save time by automating common workflows and responses.

Care Coordination

Securely message with teammates and other clinics

Team Collaboration

Securely collaborate with teammates via team messaging.

Referrals

Send, receive and coordinate referrals with professional contact sharing.

Internal Notes

Take notes privately without ever leaving the conversation.

Team Inbox

Collaborate with teammates through a shared inbox.

@Paging

Streamline workflows by paging teammates within conversations.

Assignment

Assign conversations to yourself, a teammate or a group.

Phone System

Modern system built for healthcare

Professional Phone

Professional phone lines for individuals and teams, with voicemail transcription.

Documentation

See all of your calls, automatically documented in the app.

Phone Trees

Route calls to the appropriate individual or team with phone trees.

E-Fax

Send and receive e-faxes from your phone or the web.

Call Routing

Automate call routing with advanced workflows.

Multiple Lines

Give each provider or team their own phone line to streamline communication.

Common Questions

What is Spruce?

Spruce is the all-in-one platform for HIPAA-compliant healthcare communication: phone, text, fax, video, and team messaging, with a signed BAA.

Spruce is trusted by more than 40,000 of providers across primary care, mental health, and other specialties.

Is Spruce HIPAA-compliant?

Spruce supports HIPAA-compliant communications across phone, texting, faxing, and telehealth. Every eligible Spruce organization automatically receives a HIPAA Business Associate Agreement (BAA) as part of the terms of service, with no separate agreement, no opt-in, and no additional fee.

How much does Spruce cost?

Spruce is priced per user, per month. A user is any teammate you have added to your Spruce organization. Spruce offers two plan - Basic ($24/user/month) and Communicator ($49/user/month).

Can I keep my existing phone and fax numbers?

Yes. You can transfer (port) your existing business phone or fax number to Spruce, or get a new number instantly during setup.

4.9 App Store rating

Spruce is the leading platform for healthcare communication

Get Started for Free

Frequently Asked Questions

Does the free trial include a business associate agreement (BAA)?

Yes. All Spruce trials and paid plans automatically include a BAA, if yours is an organization that requires one. You electronically agree to the Spruce BAA when you create an organization on Spruce, and you can review this agreement in our terms of service.

How do I sign up for a plan?

Once you've created an account, you can sign up for a plan by navigating to Settings > Plan & Billing in the Spruce web app on a desktop computer.

When does billing begin?

You do not need to sign up for a plan—or enter a credit card—during your free trial period. After your trial ends, you must sign up for a plan to continue using Spruce, and billing will begin when you sign up. If you sign up for a plan before your free trial ends, billing will begin only after your trial expires.

Spruce's free trial provides access to all the functionality of our Basic plan, with the exception of sending SMS text messages, as this feature requires an industry-standard registration process.

If you would like to send SMS texts during your trial, you must sign up for a Spruce plan, pay the industry-imposed SMS registration fee, and complete your business registration.

If you would like to test Communicator-level features while on your free Spruce trial, please reach out to us to discuss your goals with our sales team. We're dedicated to giving you the best look at Spruce that we can!

How long is my contract? Is it easy to cancel?

Spruce offers month-to-month contracts and billing by default. For larger practices, we may require an annual commitment (with onboarding fees) to ensure a smooth and supported transition onto Spruce, and ongoing account management to help you get the most value from our platform.
‍
We want to earn your trust every month by providing a great service, not by locking you into a long-term obligation unnecessarily. If your plan is month-to-month, you can cancel anytime directly within Spruce, and we’ll prorate your final bill. For customers on an annual contract, we’re happy to discuss options if your needs change.

If you’re considering canceling, we'll prorate the bill for your current service period. We’d also love to hear from you first—our goal is to make Spruce the easiest and most valuable choice for every practice, and we welcome any feedback on how we can improve.

How do I see my invoices?

A PDF file of your monthly invoice will be sent to your organization's billing email address every month. If you are having trouble finding these invoice records, try searching for “Spruce Health Inc” in your email client, and please make sure that you are searching the email account of your billing contact. If you are unsure of your organization's current billing email address, you can find it in the "Billing Settings" section of the Spruce web application.

Are there any additional fees?

Starting November 1st, 2025, in addition to your subscription, your monthly invoice will include applicable sales and telecommunication taxes, as well as related fees. These may comprise federal, state, and local surcharges for telecommunication services like VoIP calling, e911 services, and texting. They are pass-through charges, with no markup from Spruce, and the amount will vary based on your business address. You can learn more about these charges, including tax exemption submission, in our Help Center.

The following additional charges may also apply:

There is a one-time fee of $19.50 to enable outbound SMS text messaging for your organization on Spruce. This is the mandatory telecom industry fee for registering business SMS traffic with the major telecom carrier networks. This industry fee is not related to Spruce services and is being passed along without markup. The fee is charged only once per organization on Spruce, regardless of the number of business phone lines in use, and the fee will not be charged if your organization opts out of SMS messaging. Learn more about phone registration.

If you choose to use Spruce VoIP desk phones, we will bill the phone hardware that you choose as a one-time charge, separate from your Spruce subscription.

We may also require an onboarding fee for our larger practices, where additional setup, training, and customization are required to ensure a smooth and successful transition to Spruce. This fee helps cover the hands-on support we provide to get you up and running successfully. Feel free to contact us to learn more about this.

How do I change my plan or update my billing information?

You can change your Spruce plan or update your billing information right from Spruce—just navigate to the Spruce billing settings page in a desktop web browser. For more information, including answers to common billing and plan questions, visit our help center: Plan Changes and Payment Method Updates.

For all other billing and plan questions, you can send our support team a message at any time right through Spruce. We're always happy to help!

How is my bill determined? What counts as a user on Spruce?

Spruce is priced per user, per month. A user is any teammate you have added to your Spruce organization. Generally, this will include all clinicians, staff, and other employees (but not your patients). Spruce is not priced by number of phone lines or amount of feature usage.

All users in a single organization must be on the same billing plan.

Example: A clinic with 3 physicians, 2 nurses, 1 front-desk assistant, and 1 virtual assistant will have 7 total users on Spruce, all on the same plan and with the same cost per user.

Whenever you add or remove a teammate on Spruce, your bill will automatically increase or decrease to reflect the change.

Are there usage limits?

We've worked hard to make our monthly per-seat pricing model match the usage needs of all types of medical practices, regardless of organization size. Because of this, the vast majority of practices can (and do!) use all of Spruce's features in an effectively unlimited way, and we do not charge individually for texts, video calls, voice minutes, or other feature use. We also do not have any hard caps or automatic schedules of "overage" charges, and there will never be any surprise upcharges on your bill.

This fixed pricing works best for nearly all Spruce customers, as our goal is for you to be able to use Spruce as much and as often as possible, without having to worry about a bill that might be quietly ballooning in the background.

In the rare case that an organization's heavy use of Spruce is not compatible with the pricing of its chosen plan, we will reach out to the organization to describe the issue and to negotiate a custom price.

If you are concerned that your planned use of Spruce might be unusual, please feel free to ask our sales team ahead of time. As a general guide, extreme per-person usage of voice minutes, video minutes, SMS messages, and fax pages would be most likely to benefit from a custom pricing discussion.

How many phone and fax lines does Spruce support?

Spruce can support any number of phone and fax lines for your organization, and the system is designed to let users provision and configure new lines in a self-service manner.

By default, your subscription plan will determine the number of phone lines that your organization can provision:
• Basic: One line for each user, plus one additional line
• Communicator: Two lines for each user, plus one additional line

Fax lines work the same way. So a 3-user practice on our Basic plan could set up 4 phone lines and 4 fax lines without needing any help from our support team.

If your situation will require more lines than your subscription plan will allow for, just message our support team in the Spruce app, and we'll help you sort it out.

Still have questions? Visit our Help Center

4.9 App Store rating

Join over 25,000 healthcare professionals today

Get started with an unlimited 14-day free trial.

Get Started for Free See a Demo