Last revised: 5/19/2021

Patient Messaging Consent

Amazing Life Chiropractic & Wellness 

800 164th St SE, Suite O Mill Creek, WA 98012-8012

If you have any questions about the above notice, please contact our Office at 

425-737-5343

By supplying my home phone number, mobile phone number, email address, and any other personal contact information, I authorize my healthcare provider to use my personal information, the name of my care provider, the time and place of my scheduled appointment(s), and other limited information, for the purposes of notifying me of a pending appointment, a missed appointment, overdue wellness exam, balance due, lab results, or other communications via an automated outreach and messaging system. I also authorize my health care provider to disclose to third parties who may intercept these messages (individuals you have provided with access to your digital devices or email accounts) limited protected health information (PHI) regarding health care events. I consent to receiving multiple messages per day from the automated outreach and messaging system, when necessary.