Text Messaging Authorization Form"*" indicates required fieldsClient Name* First Last Primary Contact Name*Primary Phone Number*This is a* Cell Home WorkAlternate Contact NamePhone NumberThis is a Cell Home WorkExpanding Our Communication: We are now introducing text messaging communication in order to improve client services. We hope to utilize text messaging to provide you with timely: Hospitalized Patient Updates Lab Results Appointment Reminders Medication Status Vaccination Reminders Post Visit Follow-Up And more!YES! I would like to receive expedited reminders, updates, and results via text. This will ensure the fastest response time.I would prefer to speak with a client service representative for more information.Signature*Date* MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.
