Communications Consent Form Name Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Title First Last Email Enter Email Confirm Email Date Day Month Year Mobile NumberPatient ConsentWe need to have your consent to begin communicating with you by text or email. Please tick to accept in the boxes below. I consent to the practice contacting me by text message 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 still rests with me. 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. I understand I can cancel the text message facility at any time. Privacy ConsentThis form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.Consent I consent to the practice collecting and storing my data from this form. Optional