Ascension

Consent to Communicate Electronically

Ascension and its designees (Ascension) are asking for your consent to communicate with you electronically.

What types of communication could be sent to me?

Ascension may communicate messages about your health care services and experiences such as updates from your doctor’s office, information about your appointments or bills, general messages about Ascension’s services, or opportunities to provide feedback on your experience.

How might I receive communications?

Communications may be sent through one or more of the following: email, text message (SMS), telephone or internet phone also known as Voice over Internet Protocol (VoIP) and may use an automatic telephone dialing system or an artificial or prerecorded voice.

Will the communications be secure?

Emails will usually be sent encrypted but some emails with limited personal information may not be. Text messages cannot be encrypted. Unencrypted messages are not secure. While the risk is low, unencrypted messages could be intercepted or read by a third party and Ascension cannot guarantee that these messages will remain secure and confidential.

Are there any costs to me for these communications?

Standard text messaging rates may apply; contact your wireless carrier for details.

What if I do not want to receive these communications?

You are not required to agree to receive these communications and you can opt out from the sender at any time by replying Stop to any text message, clicking Unsubscribe from any email, or by contacting your Ascension provider’s office directly. Your choices for this consent will apply except to the extent you have implied or otherwise selected a different consent applicable to a specific Ascension facility or service (a “local” consent) or set communications preferences (for example, in your patient portal).

Ascension

Consent to Communicate Electronically

Please read this form completely and make sure that you understand. By agreeing to this consent form, you allow Ascension, and its designees, to communicate with you electronically about your health care services and experiences with Ascension. This may be by email, text message, or phone.

Ascension as used in this consent refers to affiliates or subsidiaries of Ascension Health d/b/a Ascension Healthcare, and its and their designees who perform activities on behalf of Ascension and its affiliates or subsidiaries. Your choices with respect to this consent will apply to your encounters and information associated with your clinical visits at Ascension providers, except to the extent you have signed an additional or different consent applicable to a specific Ascension facility or service (a “local” consent”, such as for Ascension Rx pharmacy communications) or set communication preferences (for example, in your patient portal account).

By agreeing to this consent, you agree and understand that:

• Ascension and its designees can communicate with you by electronic means including, but not limited to email, text message (SMS), and telephone, including VOIP (voice over internet provider), using pre-recorded messages, artificial voice messages, automatic telephone dialing devices, or other computer assisted technology, at the phone number and/or email address on file with Ascension. 

• Communications will include messages related to your health care services from Ascension, including but not limited to: appointment information and reminders, billing and collection information and reminders, visit follow up purposes, including asking for feedback on your experience, general health related information and reminders, and notifications about Ascension related services, resources, or opportunities.

• Standard text messaging rates may apply as provided in your wireless plan (contact your carrier for details).

• Texting (SMS) is not a secure method of transmission and the information contained in the text message is not encrypted. While the risk is low, the message could be intercepted or read by a third party and Ascension cannot guarantee that text messages will remain secure and confidential. 

• Email communications will usually be sent encrypted, but some messages with limited personal information may not be sent encrypted. Unencrypted email is not a secure method of transmission and the information contained in the message could be intercepted or read by a third party. While the risk  is low, Ascension cannot guarantee that the message will remain secure and confidential.

Withdrawing Consent

I understand that I am not required to agree to this consent in order to obtain services from Ascension. I understand that I may change my preferences at any time, by either replying STOP to any automated text message (which will stop text messages from that sender), clicking “Unsubscribe” from and email (which will stop messages from that sender), or by contacting my Ascension provider office directly for assistance.