Patient Registration

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Annie Information and 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 healthcare team directly when there are health issues.
  • Using SMS text messaging is not secure, and there are costs for sending and receiving texts.
  • Using Annie is voluntary, collection of patient’s 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

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Patient's Preferences

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Patient Info

(Used to receive messages)

Please check the mobile phone number entered. Our records show it is currently in use. If you still have a problem, contact our Help Desk at XXXX.

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