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Electronic Communication Consent Form

Get informed consent from patients before communicating via email, text, and patient portals. Easy to customize, embed, and integrate. HIPAA compliance option.

Page 1

Please read and agree to the following terms before consenting to electronic communication.

Email*

Introduction*

Consent to Electronic Communication*

I agree to receive electronic communication from the healthcare provider.

Patient Name*

Date*

Select date

Signature*

Description:Get electronic communication consent from patients with ease using this customizable form. Ensure HIPAA compliance when communicating via email, text, and patient portals. Embed and integrate the form seamlessly.

Electronic communication is a convenient way to communicate with patients, but it's important to obtain their consent before doing so. This electronic communication consent form template makes it easy to get informed consent from patients before communicating via email, text, or patient portals. The form is customizable, allowing you to tailor it to your specific needs. You can embed the form on your website or integrate it with your electronic health record (EHR) system. The form also includes an option for HIPAA compliance, ensuring that patient information is protected. With this form, you can streamline the process of obtaining electronic communication consent and ensure that you are following best practices for patient privacy and security.

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Patient's Date of Birth*

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