Text Messaging Consent

I authorize Cynergy Rehab Group to contact me by SMS text message for appointment reminders and important updates. I understand that message/data rates may apply to messages sent by Cynergy Rehab Group under my mobile phone plan

I may opt-out of receiving these communications at any time by calling Cynergy Rehab Group at (870) 336-0238, or by responding STOP to any text message received.

I understand that text messaging is not a secure format of communication. There is some risk that individually identifiable health information or other sensitive or confidential information contained in such text may be misdirected, disclosed to or intercepted by unauthorized third parties. Information included in text messages may include your first name, date/time of appointments, name of physician, and physician phone number, or other pertinent information.

I accept the risk explained above and consent to receive text messages via automated technology from Cynergy Rehab Group at the mobile number provided on my Child Information Form.