Edenfield Road Surgery
Request to receive SMS text messages
Please read the following carefully before deciding whether or not you wish to complete the form
below and hand it in at reception.
If you do hand in the form, we will activate the service for you, using the mobile number you supply.
At first, we will be using a simple system which only sends messages to you, reminding you of
appointments and advising you that test results are available. Subject to funding, we may later
upgrade this to an interactive service which will allow you to reply to our texts eg to cancel an
appointment which is no longer required when you get a reminder etc.
You can change your number with us at any time in writing or by phone. Your new number will
become permanent until/unless you change it again. Beware of this if registering a temporary
number with us.
Remember that text messaging is not secure. We will try to keep the content of the texts as basic as
possible, but remember that if your mobile is lost/stolen, or if someone else gets access to it,
information that you exchange with us may fall into the wrong hands. It is up to you to protect
against this. If this is a particular problem for you, please do not use the service.
In order to receive messages, please fill in and return the slip below.
I have read the above information, and would like to receive SMS text messages from the surgery
Name _______________________________ Date of Birth __________________________
Mobile number to be used for messaging ______________________________________