Bay Animal Hospital
AUTHORIZATION TO SEND TEXT MESSAGES
By signing this form, I authorize Bay Animal Hospital to send text messages to my cell phone informing me of important information relating to my pet(s) appointments and health. I understand that standard text messaging rates may apply to any messages received from Bay Animal Hospital. I also understand that I, or Bay Animal Hospital may revoke this permission in writing at any time. I agree not to hold Bay Animal Hospital liable for any electronic messaging charges or fees generated by this service. I further agree that in the event my cell phone number and/or cell phone provider changes I will inform Bay Animal Hospital. You are not required to authorize the use of text messaging and a decision not to sign this authorization will not affect your pet’s care in any way. If you prefer to not to authorize the use of text messaging, we will continue to use U.S. mail, e-mail or the telephone to communicate with you.
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I accept and DO want to receive text messages.
I decline and DO NOT want to receive text messages at this time.
This authorization will remain in effect until revoked by me in writing.
Name:
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Date
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Month
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Day
Year
Date
Cell phone number:
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Please enter a valid phone number.
Format: (000) 000-0000.
Cell phone provider:
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Please enter a valid phone number.
Format: (000) 000-0000.
Signature
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Submit
Should be Empty: