Gedeon Medical Center
SMS Communication Consent Form

Patient Name:

Date of Birth:

Mobile Number:

I consent to receive SMS text messages from Gedeon Medical Center to the phone number I have provided via the use of an automated messaging system regarding my healthcare, including:

Appointment reminders
Test results
Prescription notifications
Practice updates

Message frequency varies (typically 2-4/month). Standard messaging rates apply.

Consent to Receive SMS MessagesI consent to receive SMS messagesI do not consent at this time

Signature (Type Full Name):

Gedeon Medical Center SMS Communication Consent Form

Gedeon Medical Center
SMS Communication Consent Form