SMS and Email Consent

Consent to receive communications by SMS text or email.

As a practice, we are reviewing the way our patient’s receive information about their care. Your GP would like to be able to communicate with you by SMS text and/or email. Providing your consent for this will allow us to let you know of appointments, health promotions, important updates of results, referrals, advice, as well as vaccination and screening programmes.

If you consent to us communicating by SMS and/or email please complete the online form below.

SMS and Email Consent Form

Full Name*
Date of Birth*
DD slash MM slash YYYY
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
NHS Number
Mobile Telephone Number*
Email*
Enter Email Confirm Email
I consent to receive communications from Sid Valley Practice by SMS*
I acknowledge that text messages, emails and voicemails are an additional service and that they may not be sent on all occasions. The responsibility for attending appointments and cancelling them as well as contacting the Practice to obtain the results of recent tests still rests with me. I can cancel the text message and/or email facility at any time. Text messages are generated using a secure facility but I understand that they are transmitted over a public network onto a personal telephone and as such may not be secure.
I consent to receive communications from Sid Valley Practice by Email*
I acknowledge that text messages, emails and voicemails are an additional service and that they may not be sent on all occasions. The responsibility for attending appointments and cancelling them as well as contacting the Practice to obtain the results of recent tests still rests with me. I can cancel the text message and/or email facility at any time. Emails are generated using a secure facility but I understand that they are transmitted over a public network onto a personal email accounts or landlines and as such may not be secure. We will only send the minimum amount of personal identifiable information needed to convey the message.
Consent*
I agree the information provided is accurate and that I am the named patient completing this form.
Consent*
I agree to the privacy policy.
Please note that no medical information or questions will be responded to. The data you supply on this form will be stored on our website, which is hosted by a third party, until it has been processed by the practice. The data will be used lawfully, in accordance with the Data Protection Act 2018, which gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly. The practice privacy policy can be viewed on this website.
Signature*
Date*
DD slash MM slash YYYY

This service is available for patients aged 16 and over.

We always strive to maintain confidentiality of your information and will continue to do so while using this system. To help us do this, it is important that you let us know if you change your mobile number or email address in the future.

If you give consent for us to communicate with you by mobile text messaging and / or email as outlined above please fill in the form below. If you decide you no longer wish to receive messages through this service please inform us.

SMS and Email Consent Form

Helpful links

Further Info