We build therapist websites and sell visibility plans, so we have an interest in how a site hands people over to you. To keep this guide fair, the wording below works on any site or scheduler, every rule and platform detail comes from its own published page, and anything that is our recommendation says so.
What happens between an inquiry and a first session?
Four things happen, and each one is a place where an inquiry can stall. The person writes. You confirm you got it. You answer what they need to decide, usually your fee, your insurance position and whether you have openings. They book, or they don’t.
| Step | What the person needs | What you do |
|---|---|---|
| 1. Acknowledge | To know the message arrived and when to expect an answer | Send a short, neutral reply the same business day |
| 2. Answer | Your fee, your insurance position and whether you have openings | Say all three plainly, in your reply or on a call |
| 3. Talk | A sense of whether you are a fit | Offer a short call and say what it is for |
| 4. Book | A first appointment and what happens next | Offer times, or a booking link that shows real openings, then confirm |
How fast do you need to reply to a therapy inquiry?
As fast as you can keep up on your busiest week, and we could not find a study that names a number of hours.
The closest evidence we found measures whether therapists answer at all. In a randomized email audit published in 2022, researchers sent appointment requests from simulated clients to 725 Chicago therapists listed in an online directory. 21.7% did not return the email. 32.5% replied even though they could not take the client, and 45.7% replied and “offered an appointment or the opportunity to discuss the matter further.”1 The abstract reports whether providers replied and how responsive they were, not how quickly they replied. The study covered one city and one online directory, and its simulated clients never booked a session.
Meanwhile, the platforms describe a fast path. Rula’s help page says a new patient can see a provider “as soon as tomorrow.”2 Grow Therapy’s says you can schedule a first appointment “using the interactive availability calendar,” and that its filters can show providers “available within 72 hours.”3 Headway’s says a provider’s profile shows, “under their availability,” a “Book session” or “Book phone call” button.4 We can’t tell how many people compare several options. Someone who does may look in your reply for what those pages show: an open time, a way to book and a next step.
Our recommendation is to send a short acknowledgement the same business day and the full answer within a window you publish. Our guide to what a therapy contact form should ask explains how to choose that window and where to state it.
What should your first reply say?
It should confirm you got the message, say when a real reply will come and name an emergency number, and leave out anything about why the person wrote.
Email carries privacy risk, and HHS’s answer is practical. Its FAQ says the Privacy Rule lets covered providers use email with patients “provided they apply reasonable safeguards,” such as “checking the e-mail address for accuracy before sending” and “limiting the amount or type of information disclosed through the unencrypted e-mail.”5 The same FAQ says a person has the right to ask you to communicate “by alternative means or at alternative locations, if reasonable,” so ask early how each person wants to be contacted.5 Whether HIPAA covers your practice at all is a separate question that our contact form guide answers. This guide is general information, not legal advice.
On text messages we found less. HHS’s email FAQ doesn’t mention them, and we could not find an equivalent HHS FAQ for texting. HHS’s 2023 resource on remote communication lists “text messaging” among the messaging technologies a patient may use to send questions and get responses, and suggests making sure the patient knows “when and how they will be contacted,” for example by giving the email address or phone number messages will come from.6 The resource is written for telehealth, it is a suggestion, and it says the HIPAA Rules “do not require covered health care providers to educate patients about these risks.”6 We apply it by analogy to people who have only written to you.
Copy-ready acknowledgement
Subject: Your message to [practice name]
Hello, and thank you for writing. This is a short note to confirm that your message arrived. I read messages on [days] and will reply by [day and time zone] from this address.
I’m glad to talk about fees and insurance when I reply. To protect your privacy, please leave details about your history or symptoms out of email. We can talk about what you are looking for when we speak.
If you are in crisis, call or text 988. If you are in danger, call 911 or go to the nearest emergency room.
[Your name, credentials and practice phone number]
Three rules for the wording. Fill in a real day, not “soon.” Don’t repeat what the person wrote or say they will be a client. Change the window when you are away. The crisis lines come from SAMHSA’s crisis page, which says that anyone in danger or having a medical emergency should “call 911 or go to your nearest emergency room,” and that anyone “struggling or in crisis” can call or text 988.7
If a form tool or scheduler sends this reply for you, send a test to an address you don’t own and check that it lands in the inbox, not in spam. Our guide to why a therapist website gets few inquiries covers that check.
What should a short consult call cover?
Fit and logistics, in about 15 minutes: whether you can help with what the person describes, the practical details, your fee and how booking works.
Headway’s help page says providers choose: “Some prefer to start with a ~15 minute introductory phone call (phone consultation), while others will go right to a full session for the first meeting.”4 We found no rule that requires a consult call. If you offer one, here is an outline:
- Open (1 minute). Confirm it is a good time and that the person is somewhere private. Say how long the call is and what it is for.
- Listen (5 minutes). Ask what they hope for, in a sentence or two. Whether you are the right clinician is your judgment, and this guide doesn’t cover it.
- Check the practical fit (2 minutes). Where they live and will attend sessions from (your board’s telehealth rules decide whether you can see them), the session format, and their available days against your openings.
- State your fee and insurance position (2 minutes). Your fee for each session length. Whether you are in network with any plan or out of network. Whether you keep sliding-scale spots and whether one is open.
- Say what happens next (2 minutes). Offer to book now, or say when you will follow up. Ask how it is all right to contact them, including whether you may leave a voicemail.
- Close. Repeat the next step and the date.
The minutes are our suggestion. If the call runs long, cut step 2 or 3 short and keep step 4.
Does talking about your fee on the call trigger anything under federal law?
Yes, when the person is paying without insurance: the rule says to treat a conversation about cost as a request for a written Good Faith Estimate.
Under 45 CFR 149.610, a provider must tell uninsured or self-pay people that an estimate is available, and that information must be “Orally provided when scheduling an item or service or when questions about the cost of items or services occur.” The rule also says, in paragraph (b)(1)(iv), to “consider any discussion or inquiry regarding the potential costs of items or services under consideration as a request for a good faith estimate.” An estimate requested this way is due “Not later than 3 business days after the date of the request,” and one for care scheduled at least 3 business days ahead is due “Not later than 1 business day after the date of scheduling.”8
A line you can say on the call: “If you’re not using insurance, you have the right to a written Good Faith Estimate of my fees. I can send one today.” The simplest habit is to send it the day you quote the fee, which is inside every deadline above. Our fees guide covers the notice your website needs, and our guide to private-pay clients covers what the estimate must contain. This is general information, not legal advice.
What should a “what happens next” block say?
It should say who will reply, from which address or number, by when, what the first call is and what it costs, in a few lines on the page people see after they write.
Put it beside the form and again on the confirmation screen. HHS’s 2023 telehealth resource suggests telling patients “the email address or phone number from where information will be sent to them,” which HHS says helps patients avoid “potential phishing emails or other scams.”6
Copy-ready block
What happens next
1. I read messages on [days]. You will hear from me by [day and time zone], from [email address or phone number].
2. If you would like, we can talk for about [15] minutes by [phone or video] to see whether we are a good fit. [The call is free. / The call costs $[amount].]
3. On the call I will tell you my fee ($[amount] for a [45]-minute session), whether I take insurance, and when I have openings.
4. If we both want to go ahead, we will book your first session then or by email.
5. If you are not using insurance, you can ask me for a written Good Faith Estimate at any time.
If you are in crisis, call or text 988. If you are in danger, call 911 or go to the nearest emergency room.
Fill every bracket with something true today. If your openings change weekly, leave dates out and say you will reply with current times. If you book through SimplePractice, our guide to adding SimplePractice booking to your website covers the link, and our guide to adding TherapyNotes, Jane or IntakeQ booking covers those three.
What should you say when you have no openings?
Reply anyway, and put the answer in the first line.
In the audit above, 32.5% of therapists wrote back even though they could not take the client, and the researchers counted that as “somewhat responsive.”1 A reply that says you are full lets the person look elsewhere sooner. Say when you expect an opening, if you know, and name a referral source you trust.
Thank you for writing. I’m not taking new clients right now, and I expect to have an opening around [month]. If that timing works for you, reply and I will write to you when I do. If you need to start sooner, [name a directory or referral source you trust] is a good place to look. If you are in crisis, call or text 988.
How do you know whether your reply time is the problem?
Count it for a month: the date each inquiry arrived, the date you answered and what happened next, with no names.
A three-column note is enough. After a month you will see how many inquiries came, how many got an answer inside your window and how many booked. We found no published benchmark for these numbers, so compare yourself with last month, not with a figure from the internet.
Questions therapists also ask
Do I have to offer a free consult call?
We found no rule that requires one. Headway’s help page describes some providers starting with an introductory call and others going straight to a full session.4 Pick one, say which on your website, and keep it. If the call has a fee, state it.
Can I answer inquiries by text?
HHS’s email FAQ is about email, and we could not find an equivalent HHS FAQ on text messages.5 HHS’s 2023 telehealth resource names text messaging among messaging technologies and suggests telling patients when and how they will be contacted.6 If you do text, say which number you will text from, let the person choose, and keep texts to scheduling. Other laws may also apply to text messages, so ask an attorney.
Can I quote my fee in my first email?
We found nothing that prevents it, and a fee is not clinical information. If the person is not using insurance, a cost discussion by email also counts as a request for a Good Faith Estimate under the rule quoted above, so plan to send the written estimate.8
What if I don’t hear back after I reply?
Send one follow-up after your window passes. Say you haven’t heard back, that you are closing the inquiry, and that they are welcome to write again. That is our suggestion. We found no rule or study on follow-up messages.
Where to start
This guide is general information, not legal advice. For your own practice, ask your licensing board, your professional association’s ethics line or an attorney. Do two things this week: put your reply window and the “what happens next” block on your contact page, and set up the acknowledgement so it goes out the same business day. Our websites connect to the scheduler you already use, and consultation requests go to that scheduler or to your email. If you want help with the site side, find the plan that fits your practice.
If you want a site built and kept for you, see website design for therapists.