Consent to Text and Email

    Consent to email or Text Usage for Appointment Reminders and Other Healthcare

    I give my psychologist permission to enter my name and phone number in her password
    protected phone, and to use her phone calendar to schedule my appointments. I
    understand that confidentiality cannot be guaranteed through the internet or text
    messaging and any engagement in such forms of communication, I take at my own risk.
    Client may be contacted via email and/or text messaging to remind you of an appointment,
    reschedule an appointment, and to provide general health reminders or information. I understand
    that once I have consented to receive communication via text or email, I still have the right to
    revoke that consent at any time.

    If at any time I provide an email or text address at which I may be contacted, I consent to
    receiving appointment reminders and other healthcare communications at that email or text
    address from Dr. Korinek. These reminders may come either directly from a phone, or via online
    appointment scheduling and reminder software. While there is no charge for this service,
    standard text messaging and data rates may apply as provided in your wireless plan.

    (Initials) I consent to receive text and voice messages from Dr. Lauri Korinek on my cell
    phone and any number forwarded or transferred to that number, and to receive emails messages
    providing communication as stated above. I understand that this request to receive emails, and
    text and voice messages will apply to all future appointment reminders/health information unless
    I request a change in writing.

    The cell phone number that I authorize to receive text or voice messages for appointment
    reminders and general health information is:

    The email that I authorize to receive email messages for appointment reminders and
    general health information is

    Comments are closed.