Who this is for:

If you've already read our trigger troubleshooting guide and suspect a problem with your filtering or configuration, this cheat sheet highlights the most common trigger configuration issues we see regularly.

Trigger misconfigurations typically happen in one of these two places:

Your trigger type (the event that fires the trigger)
Your trigger filters (the targeting you've applied to your trigger)

Start by looking for your trigger's type in the table below and check out the most common misconfigurations.

1️⃣ Trigger type (timing) issues

⏱️ Delivery timing for transactional emails

Transactional emails (like appointment confirmations and reminders) may be delivered 10–15 minutes after your configured send time. This is separate from test emails, which send immediately.

Example:

If you set a confirmation email to send 5 minutes after an appointment is created, it might actually arrive 15–20 minutes after the appointment is booked.

Why does this happen?

Peptalkr sends emails in controlled batches rather than all at once. This keeps the platform stable and reliable for all users, preventing email delays or failures during busy periods.

Does this affect my patients?

Not really! Here's why:

A few extra minutes rarely matters for appointment confirmations—patients aren't watching the clock
Reminders are sent hours or days in advance, so 10–15 minutes makes no practical difference
Your patients still get timely, helpful communication

When it might matter

If you're wanting to send extremely time-sensitive communications (like "Your practitioner is running late" messages), keep this delay in mind when setting your timing.

For most clinics and most communications, this small delay won't be noticeable to your patients.

The most common cause of timing issues is using the wrong trigger type for your email.

Each trigger type is designed for a specific purpose and timing. Using the wrong one means your email won't send when you expect it to—or might not send at all.

Common mistake: Using "Before the appointment" for confirmation emails. This won't work because confirmation emails need to send immediately after booking, not before the appointment happens.

The fix: Use "After an appointment is created" for any confirmation or welcome email that sends at the time of booking.

Quick reference guide:

Trigger type	Common misconfigurations
Before the appointment	This is used for reminders and any email that sends in the leadup to an appointment. It is not for confirmations. Have you ticked the reminder checkbox? This ensures it will only fire if the patient has email reminders enabled in their Cliniko communication preferences. New patients typically haven't set this yet, so we only recommend activating this setting for returning patient visits.
After the appointment	This is for any email that sends any amount of time after an appointment - including follow ups, feedback and longer term recalls. Have you ticked the is this a recall checkbox? Ticking this will ensure it only fires if the patient has not scheduled or attended another appointment since the one that fired this trigger.
After an appointment is created	This trigger type is for any email which sends at time of booking, such as confirmations and welcome emails. Have you ticked the confirmation checkbox? This ensures it will only fire if the patient has email confirmations enabled in their Cliniko communication preferences. New patients typically haven't set this yet, so we only recommend activating this setting for returning patient visits.
After an appointment is cancelled	This trigger type is for any email that sends in relation to a cancelled appointment. Have you ticked the is this a recall checkbox? Ticking this will ensure it only fires if the patient has not scheduled or attended another appointment since the one that fired this trigger.
After an appointment is marked DNA	This trigger type is for any email that sends in relation to a missed appointment (was marked Did Not Arrive in Cliniko). Have you ticked the is this a recall checkbox? Ticking this will ensure it only fires if the patient has not scheduled or attended another appointment since the one that fired this trigger.
After an invoice is created	This trigger type is used when you want to send an email at the time an invoice is created, where the invoice contains a particular line item (product or billable item). No common issues with this trigger type.
After an invoice has been paid	This trigger type is used when you want to send an email at the time an invoice is marked paid, where the invoice contains a particular line item (product or billable item). No common issues with this trigger type.
After a medical alert is added to a patient file	This trigger type is used when you want to manually trigger an email to a patient by adding a medical alert to their patient file. What's the timing of your trigger? This matters - because if you remove the medical alert before the email is set to send to the patient, it won't send as we re-check the medical alert is still in their file before we send the email.
When a patient has a certain number of appointments	This trigger type is used when you want to target a specific appointment number - e.g. #1, #2, #10 - either over all time, or within the last specific number of days. Are you counting over all time, or a set period of time? If you selected over a set period of time - be sure to check your timing. e.g if you set 1 day -* then this trigger is only going to send if a patient attends your chosen count of appointments in a single day.*

2️⃣ Trigger filter (targeting) issues

Now for identifying any problems with your targeting. We often see issues here - so please carefully read the table below as it solves the majority of problems.

Important tip:
There is no need to make filter selections if you are targeting everything in a filter group. For example, if you have 3 businesses - you needn't select all 3. Leave the filter blank to target all by default. This keeps your configuration cleaner. Only use filters when you need to narrow down your audience.

Filter	Common misconfigurations
Business	Are you targeting the correct business(es)? If you want to target all businesses, or you only have 1 business, remove the filters here. If you have recently added another business to your Cliniko account, check you are actually targeting it (or excluding it depending on your needs). In the above example, we want the email to target just 2 of our 3 businesses, as we will do a separate email and trigger for the London location.
Sex 🚨Super common issue!	Have you applied a sex filter? We suggest you don't! Because it's really common that patients have no "Sex" set in their patient file. As such, patients who don't have their sex set, will not receive this email at all if you have set sex targeting. It's super rare to need this filter. Best to avoid unless you're absolutely certain you only wish to target those in Cliniko with their sex set to Female or Male.
Appointment Category ~or~ Appointment Type	Does this trigger need to target just specific appointment type(s) or categories? If no, leave these blank. If yes, start by selecting the categories that should be targeting (if applicable), followed by the specific types you wish to include OR exclude. You typically don't need to target specific appointment types or categories, unless you are doing modality-specific or appointment-specific messaging. And if you're trying to target new patients/initial appointments only - we generally suggest using the appointment count filter (see below) rather than the appointment type filter.
Appointment Count 🚨Super common issue!	Are you trying to target a patient's first appointment with the count filter? The count filter counts the number of appointments a patient has already attended in the past. So what you enter here will be different, depending on whether your trigger sends before or after a first appointment is attended. If before the first appointment (e.g a confirmation, welcome email or reminder), you'd set: Exactly 0 As the patient is yet to attend their first appointment. If after the first appointment (e.g. feedback, recall etc.) you'd set: Exactly 1 As the patient has just attended their first appointment. Additionally, if you check the box, the appointment count will be based on other filters you've applied - for example if you are targeting a specific appointment category - such as 'Physiotherapy' - then this would only send if the patient is attending their first Physiotherapy appointment.

👣 Step Two - Trigger your transactional emails

📙 Glossary - All SMS triggers explained

📙 Glossary - All transactional email triggers and filters explained

Trigger troubleshooting guide

✅ Checklist - Turning on an automated recurring trigger