Patient Consent to Receive Text Messages From the Practice

Please enter your name, date of birth, current mobile number and tick the boxes below if you wish to receive information from the Practice via text sms message.

Please confirm the surgery you are registered to:

Name

Date of Birth

Mobile Number

I consent to receiving communication from the Practice by Text

I consent to receiving test results from the Practice by text

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Much Wenlock • Kingsway Lodge, Kings Street, Much Wenlock, TF13 6BL.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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