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Enable text message notifications, and we will send you important notifications via text message. Standard text messaging rates apply.
I authorize the hospital and all clinical providers who have provided care or interpreted my tests, along with any billing service and their collection agency or attorney who may work on their behalf, to contact me on my cell phone and/or home phone using pre-recorded messages, artificial voice messages, automatic telephone dialing devices or other computer-assisted technology, or by electronic mail, text messaging or by any other form of electronic communication.
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Why do we ask for Date of Birth?
Protecting your private health information is our utmost concern. In order to authenticate your account and conform to HIPAA (Health Insurance Portability and Accountability Act of 1996) security standards, we require two forms of identification. HIPAA is United States legislation that provides data privacy and security provisions for safeguarding medical information.
PayByText service Opt-In Consent
Thank you for your interest in our PayByText service. At any time you may withdraw this request to have your billing amount sent to you via SMS with the option to pay through our automated texting service by un-checking the opt-in box. If you change your mobile phone number, please update it in the edit profile section of this site.
To reach Customer Service with regard to any questions about this consent form and the pay by text process please call 877-974-1242
By checking the Enable PayByText Service box, I authorize the hospital and all clinical providers who have provided care or interpreted my tests, along with any billing service and their collection agency or attorney who may work on their behalf, to contact me on my cell phone using pre-recorded messages, artificial voice messages, automatic telephone dialing devices or other computer assisted technology, or by electronic mail, text messaging or by any other form of electronic communication.
Standard text message & data rates from your phone provider apply.
By submitting this form I agree to all of the statements outlined above.