Text Reminder Consent Form

PLEASE READ THIS IMPORTANT INFORMATION AND AGREE TO THE DECLARATION AT THE END OF THIS FORM: When completing this form you are agreeing to advise the practice if your mobile number changes or if it is no longer in your possession. If you have not informed the practice of a change then you take full responsibility for the practice sending a text message to this number if it is no longer used by you. We do not advise using shared mobile numbers as patient details are not sent for appointments bookings and reminders. I consent to the practice contacting me by text and/or email for the purpose of health promotion, appointments reminders and Friend & Family requests. I acknowledge that appointment reminders by text are an additional service and that they may not be sent on all occasions but the responsibility for attending appointments or cancelling them still rests with me. I can cancel the text message facility at any time by replying STOP to an appointment reminder or Friends & Family request. 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.

Last Updated: 24/03/2020

Text Reminder Consent Form







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