Text messaging consent status

Record SMS consent status.

Last Updated: 09/06/2022

Your Details

Name *

Date of Birth *

Mobile Number *

Email address

Text Messaging Consent

The text messages may be reminders of appointments, a request to book a specific review appointment, health questionnaires or other relevant health information.

If I change my contact details I am aware that I should inform the surgery immediately.

All patients have the right to change their minds and have this service stopped. If you no longer wish to receive these text messages please notify the practice by completing this form and recording "No do not send me any text messages".

PLEASE NOTE WE CANNOT ACCEPT INCOMING TEXT MESSAGES - IF YOU WISH TO CANCEL AN APPOINTMENT PLEASE TELEPHONE THE SURGERY OR USE YOUR ONLINE ACCOUNT.

I hereby give my consent for the practice to send Text Message to my mobile telephone. *

Yes I consent

No do not send me any text messages

Consent

THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA *

Yes No

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Text messaging consent status

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