Patient SMS Messaging Consent Form

☐ By checking this box, I consent to receive SMS text messages from Oregon Sleep Associates at the mobile number provided above. Messages may include appointment reminders, marketing messages, and general two-way communication.

By providing my consent, I understand that:

• Message frequency may vary

• Message and data rates may apply

• I can reply STOP at any time to opt out of receiving SMS messages

• I can reply HELP for assistance

I understand that consent to receive SMS messages is not a condition of receiving services.

For more information on how Oregon Sleep Associates collects, uses, and protects personal information, please review our Privacy Policy at: https://www.oregonsleepassociates.com/patient-privacy