By signing this consent form, you agree to the following terms and conditions regarding text messaging communication:
1. Consent to Receive Text (SMS) Messages:
I consent to recieve SMS text messages from Austin Neuropsychology to my provided phone number for appointment reminders, billing matters, marketing messages, and general two-way communication. Msg frequency varies. Msg & data rates may apply depending on your mobile carrier. Reply HELP for support. Reply STOP to opt out.
2. Risks of Text Messaging:
I understand that text messaging may not be a secure method of communication and that there is a risk of unauthorized access to my protected health information (PHI). I acknowledge that text messages may not be encrypted and could be intercepted by unauthorized parties.
3. Scope of Communication:
I understand that text messages from Austin Neuropsychology will be limited to general practice communications and will not include sensitive medical information, diagnosis, or treatment discussions.
4. Opting Out:
I understand that I may opt out of text messaging at any time by notifying the office in writing or replying "STOP" to any received message.
5. Message and Data Rates and Liability:
I understand that standard message and data rates may apply, depending on my mobile carrier plan, and that I am responsible for any fees incurred. We are not responsible for any charges, errors, or delays in SMS delivery caused by your carrier or third-party service providers.
6. Accuracy of Contact Information:
I agree to notify Austin Neuropsychology immediately of any changes to my contact information to ensure continued communication.
7. No Emergency Use:
I acknowledge that text messaging should not be used for urgent or emergency medical issues and that I should call 911 or visit the nearest emergency room if I require immediate medical assistance.
8. Consent Duration:
This consent remains in effect until I revoke it in writing.