I authorize The Children's Clinic of Conway and Greenbrier (also known as Conway Children's Clinic and Greenbrier Children's Clinic) to use my provided phone number(s) and email address, included in the new patient paperwork and/or listed in the electronic medical record, for the following:

• Appointment reminders
• Follow-up reminders
• Patient communication
• Billing communication
• Clinical reminders

These communications may be subject to carrier charges, if applicable, per the phone or mobile plan provided by the caregiver's cell phone carrier.

The Children's Clinic of Conway and Greenbrier will treat any email address or phone number I provide as my private email address and phone number and this contact information will not be shared by any third-party entities.

The Children's Clinic has a patient portal via InteliChart. InteliChart provides a user-friendly interface that is compatible with most web browsers and is mobile friendly. There are also apps available for both iPhone and Android operating systems. Electronic communication, listed above, will be used to enhance our patient care. Communication with The Children's Clinic, including appointment requests, refill requests, and general messages is preferred through the patient portal.

For security, InteliChart requires any new registration with their service to be via invitation only. This invitation will be sent by an employee of The Children's Clinic.

*Carrier charges may apply

Invitations are patient specific. Any siblings that need to be added to the portal need their own invitation. Unless you indicate otherwise, all children listed above will receive a portal invitation.

List additional siblings not listed above who need portal account access: