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Text Messaging and Email Consent Form

We offer appointment confirmation, appointment cancelation and account issues messages and reminders by text message and/or email. If you wish to receive these text messages and/or emails we require your consent.


If you wish to receive these text messages and/or emails, please read the disclaimer below then complete and sign this form.


I consent to Premier Wellness Healthcare contacting me by text message and/or email for the purposes of appointment reminders and account issues. I also understand that standard text messages rates may apply.


I acknowledge that the responsibility of attending appointments and canceling them still rest with me. I can opt out of text/and or email function at any time.


I agree to advise the practice of my mobile number and/or email changes if no longer in my possession.

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