I am sending the email from a citymd account over the citymd network, with the footer, hard address, and unsubscribe but am still stuck in the spm folder
You might consider having your IT Team whitelist SurveyGizmo’s IP address:
This often improves email deliverability.
SurveyGizmo also has some best practices that could be incorporated to help with the spam issue:
I hope this is helpful 🙂