Why is it important to get consent before sending marketing messages?

Consent ensures that patients understand they may receive communications from your practice and have agreed to them.

Collecting consent protects your practice from compliance risks, improves deliverability, and ensures your messages reach patients who actually want to hear from you.

Second Door helps practices collect and manage consent automatically through the Digital Front Door, making it easier to stay compliant while building a healthy messaging audience.

Why consent matters

Consent is important for three primary reasons:

Compliance: Certain communication channels—especially SMS—are regulated and require explicit permission before sending marketing messages.

Deliverability: Email providers and mobile carriers monitor how recipients interact with your messages. Messaging people who did not opt in often leads to spam complaints, unsubscribes, or blocking.

Audience quality: Patients who opt in are more likely to engage with messages, respond to outreach, and schedule care.

Sending marketing messages to people who did not request them often results in lower engagement and can damage the reputation of your sending domain or phone number.

How consent is collected and managed

Second Door automatically captures consent through the Digital Front Door when patients request an appointment or submit their information.

This process allows your practice to:

• Capture opt-in consent at the time patients provide their contact information

• Store and manage consent centrally within the patient profile

• Respect unsubscribe or opt-out requests across all messaging tools

Patients can opt out of marketing messages at any time, and those preferences are respected across future campaigns. If you need to manually opt someone out, we support that too.

Maintaining centralized consent management helps ensure messaging remains compliant and targeted to patients who want to receive communication.

SMS consent requirements

Text messaging is regulated under U.S. telecommunications laws such as the Telephone Consumer Protection Act (TCPA) and enforced by the Federal Communications Commission (FCC).

These regulations require prior express consent before sending marketing SMS messages.

Examples of marketing SMS messages include:

• Reactivation campaigns

• Promotional offers or programs

• Marketing announcements

• General promotional outreach

If SMS messages are sent without proper consent, several issues can occur:

• Mobile carriers may block your sending number

• Recipients may report the message as spam

• SMS deliverability may decline significantly

Carriers monitor complaint rates closely. If too many recipients mark messages as spam, carriers may restrict or suspend messaging from that number entirely.

Second Door's SMS functions are built to manage consent and prioritize keeping you in compliance with these regulations. For more on improving SMS performance, be sure to check out our article on the topic.

Email consent and deliverability

While email regulations differ slightly from SMS rules, consent is still critical for maintaining strong deliverability.

Mailbox providers such as Gmail, Outlook, and Yahoo monitor sender behavior closely. If recipients frequently:

• mark emails as spam

• unsubscribe immediately

• never engage with messages

Email providers may begin filtering future emails into spam folders or blocking them entirely.

High complaint rates and poor engagement are often signs of low-quality or non-consented email lists (for example, a purchased list—we strongly advise against using these).

Sending marketing messages only to patients who have opted in helps:

• improve open and click rates

• reduce spam complaints

• protect your sender reputation

A healthy, permission-based list is one of the most important factors for maintaining reliable email delivery. For more on improving email deliverability, be sure to check out our article on the topic.

Best practices for collecting consent

To maintain compliance and strong deliverability, practices should follow a few key guidelines:

• Clearly explain the types of messages patients may receive

• Collect consent when patients first provide their contact information

• Maintain a record of opt-in events

• Always include unsubscribe or opt-out options in messages

• Respect opt-out requests immediately

By collecting consent early in the patient journey and maintaining accurate preferences, your practice can build a messaging audience that is both compliant and engaged.