Submit a Request

Patient Outreach Request
This form is for existing salesMD clients who would like our patient coordinators to contact a specific patient on your behalf.
Your patients' information is protected. This form is HIPAA compliant, and all details you submit are sent securely and handled in line with HIPAA requirements.
Before you start
Have your unique practice identifier ready. Requests with an incorrect identifier will not go through.
Don't have your identifier? Ask your practice manager, or contact Abby, salesMD Operations Manager.
Completing the form
Submit one patient per form.
Include the patient's name, best phone number and email.
Add a short note on why we're reaching out (for example, a consult follow up, a rebooking or a treatment question).
Let us know if the patient prefers Spanish else we will assume English speaking.
What happens next
We aim to contact the patient within 5-10 minutes during our service hours. You will see the outcome in your weekly report.
Bulk campaigns
Please contact Abby if you have a larger list or groups of patients. She’ll set up a campaign with you.
Please note
By submitting, you confirm the patient has agreed to be contacted by your practice by phone and text. This form is not for urgent or clinical concerns; please handle those directly with the patient.