SMS Consent Form

Sign up to receive text messages from us:

J. Rapha Clinic LLC offers appointment services, reminders, general business communications, and feedback by text message. If you wish to receive those messages, we require your consent. Please complete this form and provide your consent by checking the box below after carefully reviewing the terms and conditions.

Effective Date: 4/1/24

By opting in to receive SMS messages from Company, J. Rapha Clinic LLC (“we,” “us,” “our”), you agree to these Terms and Conditions (Terms).

SMS Messaging Service

By providing my phone number, I consent to receive SMS text messages from company for appointment reminders, marketing messages, and general two-way communication about your relationship with Company. Message and Data Rates may apply.

Message Frequency

You will receive more than one message from us unless you opt out. While messaging frequency varies, you will likely receive messages pertaining to your account with us as you request or up to four messages per month. The company reserves the right to alter the frequency of messages at any time to increase or decrease the total number of messages. The company and carriers are not liable for delays or undelivered messages.

Message and Data Rates

Message and data rates may apply based on your mobile carrier’s terms.

Privacy Policy

Your information will be handled in accordance with our Privacy Policy, which you can find on our website.

Cancellation/Opt-Out Instructions

You can opt out of receiving SMS messages at any time by replying STOP to any message we send you. After you opt out of text messaging, you will receive one additional message confirming your request has been processed.

Help/Customer Support

Text the word HELP for support. You may also contact us directly at the number listed on our website for our main office.

Liability

We are not responsible for any charges, errors, or delays in SMS delivery or undelivered messages caused by your carrier or third-party service providers.

As a healthcare provider, we want you to understand the risks involved in sending and receiving health information through text messages. Texting is not a secure way to share sensitive medical details and may not fully comply with HIPAA privacy regulations. Please do not use text messaging for urgent concerns or emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.

SMS Messages Terms and Conditions