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You want your triggers to be as automated as possible. The term "automation" does not necessarily mean technology. Automation is something in place so that a decision can be made without you. For example, delegating is a form of automation. You delegate tasks to your Virtual Assistant (VA), who knows the steps involved to complete the task.
Appointment confirmation is an example of a "Set It and Forget It" system. What is appointment confirmation? It is a system whereby your VA knows the steps involved with scheduling clients. He or she has been given the tools needed to carry out this task, such as scripts to use when speaking with clients and the process for rescheduling appointments. And, finally, your VA will update you on the status of your appointments.