SMS Consent Form - Redwood Surgery

Name *

Date of Birth *

Mobile Number *

Email Address *

I give consent for Redwood Surgery to send SMS text messages / emails to me using the number /e-mail address provided and understand that it is my responsibility to keep these details up to date with the practice and to keep my phone and my messages secure. I give consent for the surgery to send a message about any aspect of my medical treatment or dealings with the practice. If I do not receive a result by text please be aware that it is your responsibility to contact the practice to receive your test results. If you change your contact details it is your responsibility to update the surgery with this information *

I consent to the practice collecting and storing my data from this form.

SMS/Email Consent Form

Further Information