From Voicemail and No-Shows to a Chiropractic Practice Running on Autopilot
Dr. Yola Fawaz was losing new patients to voicemail, spending Friday afternoons chasing appointment confirmations, and watching a database of former patients collect dust with no re-engagement plan. Here is how Vareweb built a GoHighLevel automation system that responds to every patient inquiry in 90 seconds, cut no-shows from 22% to 6%, and generated 76 new Google reviews in six months without anyone having to ask.
Client
Dr. Yola Fawaz, DC
Industry
Healthcare / Chiropractic Care
Location
Plano, TX (DFW)
Timeline
5 Weeks to Go-Live
Services
The Problem
Good Patients Were Slipping Through
the Cracks Every Single Week
The clinic was busy. The care was excellent. The referrals were coming in. None of that helped the leads that got voicemail and never called back, the appointments that were never confirmed and simply did not show, or the former patients who had not heard from the practice in eight months.
PROBLEM 01
New Patient Inquiries Were Going to Voicemail - and Straight to a Competitor
Dr. Yola's front desk team was excellent at managing the patients already in the clinic. What they could not do was answer the phone while adjusting a patient, during lunch, or at 7pm when someone finally had time to call about their back pain. A new patient inquiry during those windows went to voicemail. Most of those callers never left a message. They called the next chiropractic clinic in the Google results instead.
"We had no idea how many people were calling and not reaching us. We just knew we weren't as full as we should have been."
PROBLEM 02
A 22% No-Show Rate Was Draining Revenue the Practice Had Already Earned
The national average for chiropractic no-shows sits between 15% and 22% for practices without automated reminder systems. Dr. Yola's practice was at the upper end of that range. With 55 appointments scheduled per week, that meant 12 empty slots every week. At an average visit value of $110, that was $1,320 in direct revenue loss every single week - not from a lack of patients, but from appointments that were booked and never filled. The reminder process was manual: one front desk call, once, the morning of. If the patient did not pick up, the slot stayed empty.
"We were losing over $5,000 a month to no-shows. And we were calling people to confirm appointments by hand instead of seeing patients."
PROBLEM 03
Hundreds of Former Patients Were Sitting in a Spreadsheet With No Re-Engagement Plan
Like most chiropractic practices, Dr. Yola had accumulated years of patient records - people who had completed treatment plans, people who had come in once and never returned, and people who had not been seen in six months or more. The practice had no systematic way to reach out to them. There was a vague idea that someone would "send a newsletter sometime," but no workflow, no trigger, and no capacity to execute it manually for 300+ former patients. The reactivation rate from this database was effectively zero. Fourteen Google reviews after four years in practice meant the clinic was nearly invisible in local search despite being excellent at what it did.
"We had hundreds of people who had been here and loved it. We just never had a way to stay in front of them."
What Is GoHighLevel Automation?
GHL (GoHighLevel) is an all-in-one CRM and automation platform used by clinics and service businesses to handle patient communication, appointment scheduling, follow-up sequences, reputation management, and pipeline tracking from a single dashboard. For a chiropractic practice like Dr. Yola's, it replaces five to seven separate tools with one connected system - and it runs automatically without adding to the front desk's daily workload. Everything that used to require a staff member to remember and execute now fires on its own, on time, every time.
THE GHL STACK WE BUILT
Five Automation Systems. One Platform. Zero Additional Headcount.
Every piece of the Dr. Yola Fawaz automation system lives inside GoHighLevel. One login, one dashboard, one source of truth. No Zapier duct tape connecting five different tools. No separate calendar software, no third-party review platform, no email tool that does not know about the SMS tool.
Missed Call Text-Back & New Inquiry Response
Any missed call to the clinic fires an automatic, personalized SMS within 90 seconds - keeping the conversation open before the prospective patient considers calling the next name on the list. Separate flows built for new patients versus returning patients, and separate after-hours messaging for calls outside business hours.
New Patient Welcome & Intake Sequence
The moment a new patient books an appointment, a fully automated onboarding sequence begins. Intake forms are sent immediately. A welcome email provides clinic information, what to bring, and what to expect. Directions and parking details go out 24 hours before the appointment. All without a single front desk action required.
3-Touch Appointment Reminder System
Three automated reminders fire before every scheduled appointment - 72 hours, 24 hours, and 2 hours out. Each includes a one-tap confirmation link. Patients who confirm are removed from the next reminder. No-shows trigger an immediate re-booking SMS within 30 minutes of the missed slot, recovering appointments that would otherwise be lost entirely.
45 / 90-Day Patient Reactivation Campaign
Former patients who have not been seen in 45 days enter a three-touch reactivation sequence that checks in on how they are feeling, shares a helpful piece of content about chiropractic wellness, and offers an easy path back to the schedule. No hard sell. Just a warm, human-sounding message from the clinic that reminds patients the relationship is still there.
Post-Visit Review Request Automation
When a patient's appointment is marked complete in the GHL pipeline, a review request fires automatically 24 hours later - right when the positive experience is still fresh. A sentiment filter asks patients to rate their visit first. Four- and five-star ratings receive a direct Google review link. Lower ratings go to a private feedback form so the practice can follow up before the experience becomes a public review.
HOW THE AUTOMATION WORKS
The Full Patient Journey, From First Inquiry to Google Review
From the moment a prospective patient reaches out to the moment a Google review lands on the clinic's profile, every step is automated, tracked, and logged inside GoHighLevel. This is the system that replaced the manual processes that were costing the practice new patients, filled appointment slots, and online reputation every month.
Instant SMS Response
Fires within 90 seconds. Personalized, friendly, and with a direct booking link.
Under 90 secondsCalendar Booking
Patient selects a time - auto-confirmed instantly. Intake forms sent within 5 minutes.
Intake forms sent within 5 minutesReminder Sequence
72hr, 24hr, and 2hr reminders fire automatically. One-tap confirm link on each.
3-touch sequenceVisit Completed
Pipeline stage updated. Revenue tracked. Reactivation timer starts for next visit.
Pipeline stage updatedReview Request
Sentiment filter SMS fires 24 hours post-visit. Google review link for 4-5 stars.
24hr post-visitInstant SMS Response
Fires within 90 seconds. Personalized, friendly, and with a direct booking link.
Under 90 secondsCalendar Booking
Patient selects a time - auto-confirmed instantly. Intake forms sent within 5 minutes.
Intake forms sent within 5 minutesReminder Sequence
72hr, 24hr, and 2hr reminders fire automatically. One-tap confirm link on each.
3-touch sequenceVisit Completed
Pipeline stage updated. Revenue tracked. Reactivation timer starts for next visit.
Pipeline stage updatedReview Request
Sentiment filter SMS fires 24 hours post-visit. Google review link for 4-5 stars.
24hr post-visitIF PATIENT DOES NOT BOOK AFTER STEP 1
Nurture Sequence Fires
No reply within 4 hours triggers a 3-touch educational sequence over 7 days. “The 3 most common signs you need a chiropractor.” No hard sell. Just value-first messaging that keeps the clinic top of mind while the patient is deciding.
IF PATIENT DOES NOT REAPPEAR AFTER 45 DAYS
Reactivation Campaign Begins
GHL automatically enrolls lapsed patients into the reactivation sequence. “Hi {Name}, it's been a while - we hope you're feeling well.” Three-touch campaign over 9 days with a soft path back to the schedule. Average of 14 reactivated patients per month without any front desk effort.
The Same Practice. A Completely Different Operation.
The Build Timeline
5 Weeks. Zero Disruption to the Clinic.
The entire GHL system was built, tested, and launched without interrupting the clinic's daily operations. No migration headaches. No downtime. The practice kept running exactly as it was while the new system was built alongside it, then switched on when it was ready.
Sub-Account Setup, Phone Auth & HIPAA Configuration
GHL sub-account provisioned with clinic branding. Custom values configured for business name, phone number, review link, and provider name. New clinic phone number acquired and verified through Twilio. Email sending domain authenticated (SPF, DKIM, DMARC) to ensure deliverability. HIPAA conscious message guidelines established: no protected health information transmitted via SMS or unencrypted email. All intake forms built inside GHL's secure HIPAA compliant form builder.
CRM Pipeline + Patient Segmentation Built
Five stage patient pipeline built: New Inquiry → New Patient Booked → Visit Completed → Reactivation Needed → Converted. Opportunity values attached to each stage using average visit value and treatment plan length. All existing patient records imported from the clinic's scheduling software and tagged: active, lapsed (45+ days), and former patient (90+ days). Lead sources connected: Google Business Profile, website contact form, and manual entry. Round-robin assignment disabled (solo provider practice).
Missed Call Text-Back + Booking Calendar + 3-Touch Reminder Sequence
Missed Call Text-Back workflow built and tested across 15+ inbound scenarios. GHL native calendar configured with Dr. Yola's availability windows, buffer times between appointments, and an after-hours block. Booking calendar embedded in the SMS text-back, the website, and the Google Business Profile link. The three-touch reminder sequence (72hr, 24hr, 2hr) written in clinic voice, tested through real appointment scenarios, and validated for SMS deliverability. Old Calendly subscription confirmed for cancellation upon go-live.
Reactivation Campaign + Review Request Automation Live
Patient reactivation sequences built for both the 45-day and 90-day lapsed segments. All three-touch copy reviewed and approved by Dr. Yola to ensure the tone matched how she actually speaks to patients. Review request workflow built: triggers on pipeline stage change to "Visit Completed," fires sentiment filter SMS at 24hr, routes 4-5 star responses to Google review link and 1-3 star responses to private feedback form. Manual task created in GHL for negative responses so Dr. Yola can follow up personally. Both workflows tested end-to-end with test contacts before any live patients entered the system.
Full QA, Go-Live & Team Training
End-to-end quality assurance across all five automation workflows: real test patients put through every path, including missed calls, form submissions, appointment bookings, no-shows, and post-visit review flows. Two training sessions with the front desk team covering the GHL mobile app, how to action incoming tasks, how to move patients through the pipeline, and how to read the dashboard. Dr. Yola trained separately on the owner dashboard view, revenue reporting, and how to review reactivation campaign performance. System went live with 7-day active monitoring from the Vareweb team before handoff.
The number that changed everything
The new no-show rate at Fawaz Chiropractic & Wellness. Down from 22%.
The industry average for chiropractic practices without automated reminders sits between 15% and 22%. Dr. Yola's practice hit the upper range before this build. At 6%, she is now among the top-performing practices in the country for appointment attendance - without her front desk spending a minute on reminder calls.
Numbers That Speak for Themselves
Appointment show rate
Inquiry-to-booking conversion
Reactivated patients per month
Before Vareweb built our GHL system, we were losing new patients to voicemail without knowing it, and my front desk was spending Friday afternoons calling patients to confirm Monday appointments by hand. Now the system handles all of that automatically. New patients get a response in seconds. Appointment reminders go out on their own. Reviews come in every week. And I have a clear view of every patient in our pipeline for the first time in four years. It is like having a second front desk that never takes a day off and never forgets to follow up.
Dr. Yola Fawaz, DC
Owner, Fawaz Chiropractic & Wellness, Plano, TX
Common Questions
Is GoHighLevel HIPAA compliant for a chiropractic practice?+
GHL can be configured for HIPAA-conscious use with the right setup. For Dr. Yola's build, we followed specific guidelines: no protected health information (PHI) was included in SMS messages, intake forms were built inside GHL's secure form builder rather than third-party platforms, and all communication was structured to avoid transmitting clinical details through unencrypted channels. We recommend discussing your specific compliance needs with a healthcare attorney, but the GHL platform provides the tools needed to operate within HIPAA-aware workflows when configured correctly.
Can GHL integrate with our existing scheduling software (ChiroTouch, Jane App, etc.)?+
It depends on the platform. For Dr. Yola's practice, we replaced the existing scheduling tool with GHL's native calendar, which eliminated the need for a separate integration entirely. For practices that need to keep their existing practice management software (like ChiroTouch or Jane App) for clinical documentation, we can build a parallel GHL setup for communication and marketing automation that runs alongside the existing system. We audit what you have before recommending whether to replace, integrate, or run in parallel.
How quickly did Dr. Fawaz's clinic see results?+
The no-show rate improvement was visible within the first two weeks of go-live because the reminder sequences were active from day one. The new patient booking increase became clear at the 30-day mark as the Missed Call Text-Back system started converting callers who would have previously bounced to a voicemail. The review count growth started slowly in week one and compounded each month as the post-visit automation ran consistently. The reactivation campaign results arrived in the second month after the lapsed patient segments received their first outreach.
Does this replace the front desk, or does it work alongside them?+
It works alongside the front desk. The automation handles the repetitive, time-sensitive tasks that were previously eating into front desk capacity: reminder calls, booking confirmations, intake form collection, and review requests. The front desk still handles complex patient needs, insurance questions, and in-person interactions. What they stop doing is spending Friday afternoons calling 55 patients to confirm Monday appointments. That time goes back to patient care. The system is an operational upgrade for the front desk, not a replacement.
What does GHL cost after Vareweb completes the setup?+
GHL is approximately $97 to $297 per month depending on the plan, billed directly to you. Twilio SMS costs are separate and usage-based (typically $10 to $40/month for a single-provider practice). The Vareweb setup fee is a one-time project cost. For Dr. Yola's practice, the reduction in no-shows alone recovered more than the entire setup cost in the first 60 days. Most clinic clients cover the ongoing GHL subscription cost from the first two or three reactivated patients per month.
Want a Patient System That Never Misses an Inquiry, Never Forgets a Reminder, and Never Stops Asking for Reviews?
Get a free GHL audit and see exactly what your current setup is losing - new patients to voicemail, revenue to no-shows, and reputation to a review process that never happens.