> This page is part of the [Customer.io documentation](https://docs.customer.io). For the complete index, see [llms.txt](https://docs.customer.io/llms.txt).
> Last updated: July 15, 2026

# Telehealth and weight management compliance

SMS programs in the telehealth, healthcare, and weight management sectors receive heightened review from wireless carriers and messaging providers. This page covers the rules we recommend you follow to protect your deliverability and keep your program in good standing.

 Review these requirements before you send

We strongly recommend you review these requirements in detail before sending SMS to customers in the telehealth, healthcare, or weight management sectors. SMS programs in these spaces receive heightened review from wireless carriers (AT&T, T-Mobile, Verizon) and messaging providers. A single violation can result in filtering, campaign rejection, number suspension, or loss of sending access—sometimes with little or no advance notice.

We recommend applying this guidance to **every number type**: 10DLC long codes, toll-free numbers (TFN), and short codes. We’re not aware of an exemption for any number type.

This page is carrier- and provider-focused guidance. It does not replace your responsibility to comply with applicable SMS laws, regulations, industry rules, carrier requirements, and the Customer.io Feature Terms.

This guidance is focused on SMS/MMS programs sent to recipients in the United States and Canada. Other countries may have additional or different requirements.

## Three things we strongly recommend

Based on the current Twilio guidance, we recommend treating all three of the following criteria as required for your program to stay in good standing.

### 1\. Promote your business, not products or treatments

We recommend only promoting your **business and service**. That means:

*   Driving users who have properly opted in to your own branded sign-up, account, or scheduling flow
*   Helping people connect with a provider
*   Driving traffic to your website using branded links, not public URL shorteners
*   Sharing general updates, offers, and reminders about your service

We recommend against positioning your messages around a specific medication or medical outcome.

### 2\. No medication names and no medical or pharmaceutical language

Keep all content focused on your service. We recommend avoiding:

*   Offers, promotions, or calls to action for prescription drugs, even if your provider network is licensed
*   Any medication by brand or generic name, including GLP-1 and other prescription weight management drugs
*   Clinical or pharmaceutical terms, dosing, or drug class references
*   Diagnoses, condition names, treatment references, or medical claims (for example, promises about weight loss results or treating a condition)

If a reader could not tell what specific drug or condition you are referring to from your message, you are on the right track.

### 3\. Add a date-of-birth age gate to your website

Where required, your website should verify age before or at consent capture using a **month / day / year date-of-birth entry**. This can live wherever makes sense for your flow: a site entry gate, the checkout form, or the intake form.

*   We don’t consider a simple “I am over 18” checkbox sufficient.
*   We recommend requiring the visitor to actively enter their date of birth.

## Any breach can trigger immediate suspension

Carriers and Twilio can suspend your number and campaign **instantly** for any violation of the guidance above. This often happens with no warning, and reinstatement is not guaranteed. Treat every message and every change to your site as something that must stay compliant.

## Recommended message examples

*   “Welcome to \[Brand\]. Your account is ready. Get started here: \[link\]”
*   “\[Brand\]: Your consultation is confirmed. Reply STOP to opt out.”
*   “Ready to take the next step with \[Brand\]? Find a provider: \[link\]”
*   General service reminders, appointment confirmations, and offers tied to your business

## What we recommend avoiding

*   Any drug name (brand or generic), including GLP-1 medications
*   Dosing, prescriptions, or pharmacy references
*   Condition names, diagnoses, or treatment/outcome claims
*   SHAFT content (Sex, Hate, Alcohol, Firearms, Tobacco), cannabis, or CBD
*   Anything that reads as a third-party or affiliate offer

## Remember, all standard SMS rules still apply

We recommend treating these as required for all A2P programs, enforced alongside the points above:

*   **Consent**: Only message people who have actively opted in. You cannot buy, sell, share, or transfer consent. Promotional or marketing texts require their own consent and should not be bundled with transactional or informational message consent. Keep records of the opt-in date, method, language shown, and message program consented to.
*   **Opt-in flow review**: Before you submit or send, confirm that your [phone number collection flow](/messaging/channels/sms/registration/sms-opt-in-form/) clearly identifies the sender, message purpose, whether messages are recurring, message frequency, that message and data rates may apply, how to get help, how to opt out, and links to your SMS terms and privacy policy. We recommend you collect marketing consent separately from transactional or informational message consent.
*   **Opt-out**: Honor [STOP, similar keywords](/messaging/channels/sms/keyword-opt-out/), and opt-out requests made by other reasonable methods and terms, and include opt-out language in your messages.
*   **HELP**: Respond to HELP with your brand name and support contact.
*   **Privacy policy and SMS terms**: Your site needs a [privacy policy](/messaging/channels/sms/registration/your-privacy-policy/) confirming that mobile numbers and SMS opt-in consents are not sold, shared, or transferred to third parties for their marketing, along with SMS terms that outline your STOP/HELP instructions, support contact information, program description, and any other required disclosures.
*   **Brand match**: Your registered brand, your website, and your message content must all line up. Mismatches get campaigns rejected. Use branded links only. Do not use public URL shorteners like bit.ly or tinyurl.

If you handle protected health information, see [HIPAA compliance and privacy regulations](/messaging/channels/sms/registration/hipaa-standards/) for additional safeguards.

## Opt-out and HELP

*   STOP and HELP must always work on your number.
*   Include opt-out language (for example, “Reply STOP to opt out”) in your opt-in confirmation and your first message. We recommend treating this as required.
*   Best practice: add “Reply STOP to opt out” to your recurring messages too. It is not strictly required, but it protects deliverability in this closely watched space.
*   Honor any STOP request promptly.

* * *

Questions about whether specific copy or a specific site setup passes review? Reach out to your Customer.io SMS Implementation contact before you send. It is much faster to fix copy in advance than to recover a suspended number—and we’re here to help.

*   *   [Three things we strongly recommend](#three-things-we-strongly-recommend)
        *   [1\. Promote your business, not products or treatments](#1-promote-your-business-not-products-or-treatments)
        *   [2\. No medication names and no medical or pharmaceutical language](#2-no-medication-names-and-no-medical-or-pharmaceutical-language)
        *   [3\. Add a date-of-birth age gate to your website](#3-add-a-date-of-birth-age-gate-to-your-website)
    *   [Any breach can trigger immediate suspension](#any-breach-can-trigger-immediate-suspension)
    *   [Recommended message examples](#recommended-message-examples)
    *   [What we recommend avoiding](#what-we-recommend-avoiding)
    *   [Remember, all standard SMS rules still apply](#remember-all-standard-sms-rules-still-apply)
    *   [Opt-out and HELP](#opt-out-and-help)

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