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Available Forms

*3 New Patients: Text Messaging

Authorization to Leave Personal Health Information via Text Message

Updox SMS is a non-secure way for you and Home Towne to communicate quickly. The primary use will be to connect with you via phone. Updox Secure texting is a HIPAA compliant software that allows Home Towne Family Medicine to communicate protect health information between you and our staff. Each patient is assigned a unique 800-888 number with a secure 5-digit pin you select for validation.

Patient Consent

With my name below, I acknowledge and understand that this information will be kept in my medical records and the above parameters will remain in effect until revoked by me in writing. It is my responsibility to notify my healthcare provider (s) should I wish to change one or more of the telephone numbers and/or contacts listed above.

Patient or Legally Authorized Person
* Required field