Consent to Text Messaging and E-mail Communication Name First Last Date of birth Month Day Year Contact NumberEmail Enter Email Confirm Email Thornbury Road Centre for Health would like to contact you by text message and/or e-mail. During this digital age, text messages and e-mails are an efficient way to communicate with patients. If you agree to receive text message and e-mails from the practice, this will include; • Appointment booking confirmation (text message) • Appointment booking reminders the day before your appointment (text message) • Notification of missed appointments (text message) • Requests for you to contact the surgery • Notification when test results are back, and if we need to speak to you • Reminders to book an appointment (e.g. For a immunisations, annual check-ups, blood tests) • Invitation to appointments you are eligible for (e.g. NHS health checks, cervical screening) • Health campaign information • Surgery information / updates (e.g. Change in opening hours, new service starting etc) • Information about the status of a referral to hospital or specialist service • Information about your medication and prescriptions • Information about other services (e.g. contact details)By consenting to receive text messages and e-mails, you agree to let us know if you change your mobile number or e-mail address. I agree to receive communication via text message from the practice I do not agree to receive communication via text message from the practice I agree to receive communication via e-mail from the practice I do not agree to receive communication via e-mail from the practice Please note that you can opt-out of text messaging or e-mail at any time by informing the practice.