Patient Registration

* indicates a required field

Informed Consent to Participate

Annie: VA s SMS Text Messaging Program Information & Disclosure Factsheet

  • Patient understands that Annie is for patient self-care, and that text responses are not monitored by the healthcare team;
  • Patient is responsible for their own health, and agrees to contact their healthcare team directly when there are health issues;
  • Patient understands that using SMS text messaging is not secure and that there are costs for sending and receiving SMS text messages;
  • Patient understands that using Annie is voluntary, collection of their information is subject to federal law, and how we will use their information.

Patient understands texting Start and Stop begins and ends participation in the program Provider will document above discussion occurred and participation in patient's medical record (CPRS)

Appointment/Info Messages

To subscribe, select the different message types. (Messages will be sent based on selected preference.)

To unsubscribe, deselect the message types.

Patient's Preferences

Patient's Preferences

Patient Info

(Used to receive messages)