Authorization to Leave Personal Health Information via Text Message
Updox SMS is a non-secure way for you and Home Towne Beauty 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 Beauty 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.
Please note your preferences here should be the same for medical. if you are not sure what your medical preferences are set to we can help!
With my signature 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.
Signature of Patient or Legally Authorized Signature