SMS TEXT MESSAGE & EMAIL CONSENT FORM Declaration I consent to the practice contacting me by text message and/or email for the purposes of health promotion, practice news and for appointment reminders. I acknowledge that appointment reminders by text are an additional service and that they may not be sent on all occasions but that the responsibility for attending appointments or cancelling them rests with me. I can cancel the text message facility at any time. Text messages are generated using a secure facility but I understand that they are transmitted over a public network onto a personal telephone and as such may not be secure; however the practice will not transmit any information which would enable an individual patient to be identified. I AM AWARE THAT THIS CONSENT MAY BE REVOKED BY ME AT ANY TIME. FULL NAME DATE OF BIRTH ADDRESS (incl. postcode) EMAIL ADDRESS TELEPHONE NUMBER SIGNED PRINT NAME DATE
SMS TEXT MESSAGE & EMAIL CONSENT FORM Declaration I consent to the practice contacting me by text message and/or email for the purposes of health promotion, practice news and for appointment reminders. I acknowledge that appointment reminders by text are an additional service and that they may not be sent on all occasions but that the responsibility for attending appointments or cancelling them rests with me. I can cancel the text message facility at any time. Text messages are generated using a secure facility but I understand that they are transmitted over a public network onto a personal telephone and as such may not be secure; however the practice will not transmit any information which would enable an individual patient to be identified. I AM AWARE THAT THIS CONSENT MAY BE REVOKED BY ME AT ANY TIME. FULL NAME DATE OF BIRTH ADDRESS (incl. postcode) EMAIL ADDRESS TELEPHONE NUMBER SIGNED PRINT NAME DATE
online-access-2017-online-form.docx