Text Message Consent Form

Text Message Consent Form

The Practice offers a text messaging service which is linked to your registered mobile phone number.  Examples of things it can be useful for include:

  1. to send appointment reminders, 24 hours before a scheduled face-to-face appointment with any member of the Practice team.
  2. to send useful information during or after a consultation.
  3. to ask you to call the surgery if we need to discuss something with you. 

If you would like make use of our text-messaging service, please complete this consent form.

  • Your Details

    Date of Birth
    For example, 15 3 1984
    I consent to the Practice contacting me by text message for purposes such as those described above.
    THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA.
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Page last reviewed: 04 March 2026
Page created: 04 March 2026