📝 Overview
If your clinic uses both ChiroHD and SKED, the two-way texting sync keeps text conversations visible in both platforms simultaneously. Any message sent or received in ChiroHD is reflected in SKED, and vice versa — your staff always sees the full conversation regardless of which platform they're working in.
The sync covers two contact types:
Patients/Clients — active contacts already in your ChiroHD system
Leads — prospective patients being managed in SKED before they've converted
When a lead converts to a patient in ChiroHD, their text history is not lost. The existing SKED conversation is linked to the new patient record automatically, so staff can see everything that was said before the person ever walked through the door.
Accessing the SKED Integration
Navigate to your Live location, Settings, Integrations, SKED
Location Admins only:
Non-admin users will not see the SKED SMS section in Settings. To set up or manage the SKED SMS integration, you must be a Location Admin.
Connecting ChiroHD to SKED
Please see our other resources on SKED Integration and how to connect and authorize SKED in ChiroHD.
Before Enabling SKED Texting in ChiroHD
Enabling SKED texting will automatically disable the following features in ChiroHD:
Appointment Reminders
Two-Way Texting
Lead Texting
Make sure all three of these are fully configured in SKED before connecting the accounts.
PLEASE NOTE:
Your Twilio number remains active. You will continue to be charged the $10/month to maintain the Twilio number, and if a patient sends a text to that number you will still receive it and be billed for it. To stop those charges completely you must release your Twilio number on the Twilio tab, which is permanent and cannot be undone. We recommend retaining your Twilio number until you are fully confident the new integration is the right long-term solution. Once you're certain, you can release the number at that time.
Enable SKED Texting in ChiroHD
Once your SKED integration is configured, simply toggle on SKED Texting.
How the Sync Works Day-to-Day
Once connected, all text messages route through SKED's messaging infrastructure. Both platforms display the same conversation.
A message sent from ChiroHD appears in SKED — and replies come back to both.
A message sent from SKED appears in the patient two-way texting history in ChiroHD.
Staff don't need to switch platforms to check for replies or duplicated outreach.
💬 For leads: When a lead is texted for the first time through ChiroHD, SKED creates a lead record on their side and stores a unique identifier. ChiroHD saves that identifier so all future messages route to the same conversation thread.
Lead-to-Patient Conversion
When a lead converts to a patient in ChiroHD, the system links the existing SKED conversation to the new patient record. Staff pulling up the new patient can see the full text history from before they became a patient — no gaps, no starting over.
Unread Indicator 🔵
In ChiroHD's conversation list, a blue dot next to a contact's name means there's an incoming message that hasn't been opened yet. Once a team member clicks into the conversation and reads it, the indicator clears.
NOTE: When conversations first sync from SKED after initial authentication, some may appear as unread if they contain messages not yet viewed inside ChiroHD. This is expected — the blue dot is flagging anything that needs attention.
Bulk Archive
When you first authenticate, the sync may pull in a large number of existing conversations — including ones from contacts that are already inactive or resolved. Rather than closing these one at a time, Bulk Archive lets you select multiple conversations and archive them all at once.
Recommended: Run a bulk archive shortly after your initial authentication to clear the backlog and keep your active inbox focused.
📁 Archiving a conversation does not delete it or remove any message history. It moves the conversation out of the active inbox view. Archived conversations remain accessible if you need to reference them later.
Things to Know ⚠️
SMS opt-out: If a patient or lead has opted out of SMS communications, messages will not be sent through the integration.
Feature must be enabled: The SKED SMS section only appears in Settings → Integrations if the integration is active for your location. If you don't see it, contact support to confirm it's enabled.
Per-location setup: Each location must complete the authentication separately. If your clinic has multiple locations, repeat the setup for each one.
Sending Images & Files (MMS)
The two-way texting window also supports MMS — you can send images, PDFs, audio clips, and short video clips directly to patients.
For full details on supported file types, size limits, and how to attach files, see our other resources on Sending MMS (Images & Files) in the Two-Way Texting Window.
Key Takeaways
Sync covers both Patients and Leads — full conversation history visible in either platform.
Lead text history carries over automatically when they convert to a patient.
Enabling SKED Texting disables ChiroHD's Appointment Reminders, Two-Way Texting, and Lead Texting — configure these in SKED first.
Your Twilio number keeps charging at $10/month until you manually release it — and releasing is permanent.
Run a Bulk Archive after initial authentication to clear the backlog.
Setup is per location — repeat for each clinic location.
📌 Conclusion
Use this integration if your clinic actively manages leads in SKED and patients in ChiroHD — it eliminates the need to check two inboxes and preserves conversation context across the full patient lifecycle, from first contact to active care. If the SKED section doesn't appear in your Integrations settings, you'll need to have the feature enabled for your location before setup can begin.