Navigate to: Message Center > Text Messaging
What You Need to Know
Shepherd's text messaging uses a credit-based system for all outbound messages, including direct messages, appointment notifications, and mass text messages.
Credits are sold in bundles of 5,000 for $99 and do not expire.
1 credit is 160 characters, unless special characters or emojis are used. A single text message in Shepherd may use several credits. Learn more about credit usage.
Before using these features, your account must have a text message number registered to your practice.
Quick Start Guide
Send a Message
Navigate to Message Center > Text Messaging.
Click New Message.
Search for and select the client you want to reach.
(Optional) Add a conversation title to help your team identify the thread later (max 50 characters).
Select an available phone number or enter a custom one
Click Create Chat — the conversation opens and is ready to use
Type your message and click Send
Tip: If you send certain messages frequently, set up an SMS Template first so you can populate your message with one click. Templates are created in Admin > Client Communication > SMS Templates.
Manage conversations
All conversations appear in the left-hand pane. From an open conversation, you can:
Send and receive messages
Add or edit a conversation title (all changes are logged)
Close and archive the conversation
Upload the conversation to the patient's medical record
Close a conversation
Select the conversation
Click Close
Choose either Close & Upload to Medical Record or Close Conversation (no upload)
Closed conversations are accessible by selecting the Closed button.
Understanding Credit Usage
The number of characters per credit depends on the character set used in your message.
GSM (Global System for Mobile Communications): The standard text format.
UCS-2 (Universal Character Set – 2 byte): If your message includes emojis, accented letters, or text copied from Word or a website, it may switch to UCS-2 encoding — which can result in 2–3 credits being used instead of one.
Type | Characters per credit | When it applies |
GSM | 160 | Standard letters, numbers, and basic punctuation |
UCS-2 | 70 | Emojis, accented letters, or special formatting |
Important: These characters ^ { } [ ] ~ are allowed in GSM but count as two characters, so they reduce your space faster than expected.
Photo Messaging Guidelines (MMS)
Supported Media: Images and videos
File Size: Varied, See chart below
Compression: Large files may be compressed automatically
Best Practice: Keep files optimized and under 500 KB when possible
The following file types are supported for MMS messaging in Shepherd:
File Type | Extension | Type | Max Size | Preview Supported | Download Supported |
JPEG | .jpeg | Image | 5 MB | Yes | Yes |
JPG | .jpg | Image | 5 MB | Yes | Yes |
PNG | .png | Image | 5 MB | Yes | Yes |
GIF | .gif | Image | 5 MB | Yes | Yes |
BMP | .bmp | Image | 5 MB | Yes | Yes |
TIFF | .tiff | Image | 5 MB | NO | Yes |
MP4 | .mp4 | Video | 0.5 MB | Yes | Yes |
MOV | .mov | Video | 0.5 MB | NO | Yes |
MPEG | .mpeg | Video | 0.5 MB | NO | Yes |
WEBM | .webm | Video | 0.5 MB | Yes | Yes |
Preview Supported = it can be seen visually before downloading.
Multiple Images
If you are sending multiple images or combining images with a long message, the total size of the message may exceed carrier limits and appear indefinitely as a yellow scheduled message — even if you have sufficient credits. To avoid this, send your text first, then send each image as a separate message.
If it stays yellow, you will need to resend a more broken down edited version to successfully send.
Purchasing SMS Credits
SMS credits are sold in bundles of 5,000 for $99. Purchased credits do not expire.
Charges apply only when you purchase additional credits. You can monitor usage and purchase credits under Admin > Client Communication > Message Overview.
SMS Templates
Templates let you quickly populate common messages without retyping them each time.
Create templates in Admin > Client Communication > SMS Templates, or directly from the Message Center.
Scheduled Messages
Click the clock icon in the message composer
Set a future date and time
Scheduled messages appear highlighted in yellow
Click a scheduled message to edit or cancel it before it sends
Sent Confirmation
For direct text messages and scheduled messages, you can confirm they were sent via the blue checkmark in the lower right of the message along with the time stamp beneath it.
This checkmark does not determine whether or not the text was read by the recipient.
Appointment Management
Create an appointment from a text:
Click the Make Appt icon during a conversation
You'll be redirected to the Appointment Schedule (client details are preloaded)
Once the appointment is created, click Go Back to return to the message
The appointment will appear in the conversation sidebar
Confirm an appointment from a text:
Edit appointment status from the Message Center:
Click the current appointment status to change it
Use the square icon to view or edit the full appointment details
You can manually confirm appointments that were sent an automated appointment confirmation text if clients are having difficulty. For more information, please read How Clients Confirm Appointments by SMS.
Assigning Conversations
Assign to users or teams
You can assign conversations to specific users or teams to ensure the right person is notified of new messages. A notification dot appears until one of the assignees reads the message.
Open the conversation
Add users in the Assigned Users section
Add teams in the Assigned Teams section
Assign to Patients
You can also assign one or more patients to a conversation. This enables the conversation to be automatically uploaded to the patient's medical record when the conversation is closed.
Texting opt-in and opt-out
Shepherd automatically manages client opt-in and opt-out status based on keywords.
Type | Keywords |
Opt-out (auto-unsubscribes the client) | STOP, CANCEL, UNSUBSCRIBE, END, QUIT, STOPALL, ARRETT, ARRET, ARRETE |
Opt-in (re-subscribes the client) | START, YES, UNSTOP |
After-hours Auto Response
You can configure an automatic reply for clients who text outside of your clinic's business hours. Set this up in Admin > Client Communication > Communication Preferences > Enable Automated SMS Reply Outside Office Hours.
Frequently asked questions
How do I get set up to use SMS messaging in Shepherd?
SMS numbers are registered through A2P 10DLC — your Implementation Account Manager handles this process, and it typically takes 2–3 weeks depending on the accuracy of your business information.
How do I send a message to more than one client at a time?
To send a message to multiple recipients at once — whether that's two co-owners or a small group of clients — use the Mass Communication feature. Unlike direct conversations, Mass Communication lets you select specific recipients rather than sending to an entire segment, so you can send to as few or as many clients as needed. You can also write a custom message rather than relying on a template.
Can I text from my practice's main phone number?
No. Shepherd provisions a dedicated texting line for your practice. Your main practice phone number is not used for SMS. Shepherd will attempt to match the area code of your existing number when provisioning the new line.
Can I transfer my existing number to Shepherd for texting?
Shepherd does not support hosted SMS at this time. A new number will be provisioned for your practice.
How do I enable SMS for my team members?
SMS permissions are managed under Admin > Users > Roles. You can create a custom Messaging Role and assign it to individual users.
Why is my message using more credits than expected?
The most common reasons are emojis, accented characters, or text pasted from Word or a website. These trigger UCS-2 encoding, which reduces the character limit from 160 to 70 per credit. Review your message for these characters before sending.
How do I check if a message was delivered?
You can view message status within the Message Center. A blue checkmark in the lower right of the message indicates that a message was successfully sent.
For reminder notifications specifically, check the client's Activity Log by opening the client profile and clicking the zig-zag arrow in the top right corner.
Why am I getting an error when sending pictures?
Even if you have sufficient credits, combining large files with other content in a single message can trigger an error. This is usually because the total size of the message — including images and text — exceeds carrier limits. For example, two pictures sent alongside a long message are more likely to fail than two pictures alone. To avoid this, break up your messages: send your text first, then send each image as a separate message. Keep image files under 500 KB where possible for the most reliable delivery.
Do shortcuts work in SMS text messages?
Shortcuts are not currently supported in SMS messaging. They only work in Rich Text Boxes that display the lightning bolt icon.