Yes, Apptoto does work outside of the US and Canada. Apptoto will call/text any fully qualified number (e.g. +32484231111) you place in your appointments. You can also specify your home country on the "Settings">"Contact Info" tab - setting the home country in the account tab will allow Apptoto to more accurately extract phone numbers with and without your home country's calling code. (e.g. if you select "United Kingdom" as your home country then Apptoto will be able to extract a number such as 023 1234 5678 as +442312345678).
For a full list of supported countries, please click here.