SMS Opt-In & Consent — Advanced Gastroenterology Center

SMS Consent Language

By opting in through any of the methods described below, patients agree to the following consent terms:

By providing your mobile number to Advanced Gastroenterology Center (AGC) — on our patient intake form, when scheduling by phone, or in person — you agree to receive appointment reminder, confirmation, scheduling, procedure preparation, and post-procedure follow-up text messages from AGC at the number you provide. These messages may include your appointment date, time, and location; the type of appointment or procedure; preparation instructions (such as diet and bowel-prep reminders); and instructions to confirm, reschedule, or call the office. Message frequency varies (typically 2 to 6 messages per appointment). Message and data rates may apply. Reply STOP to opt out, HELP for help. Consent is not a condition of treatment. AGC does not share your mobile opt-in information with third parties for marketing.

Last updated October 2026.

How patients give consent

Written

Patient intake & registration form

Patients write their mobile number and check a dedicated, optional consent box on our intake form. The box is unchecked by default and kept separate from any treatment consent. That consent section is shown below, and the same section appears on our online patient registration form.

Verbal

When scheduling by phone or in person

When a patient schedules by phone or in person, staff read the script below word for word, ask the patient to answer yes or no, and record the answer in AGC’s scheduling system before any texts are sent.

Verbal consent script

Staff read this script when a patient schedules by phone or in person, and record the patient’s answer in our scheduling system.

AGC staff: “Advanced Gastroenterology Center can send you text messages about your care: appointment reminders and confirmations, scheduling updates, preparation instructions before procedures, and a check-in after procedures. These texts may mention the type of appointment or procedure. You’ll typically get 2 to 6 texts per appointment. Message and data rates may apply. You can reply HELP for help or STOP to opt out at any time. Our text message terms are at pavansachan.com/sms-terms-conditions and our privacy policy is at pavansachan.com/privacy-policy. Texts are optional and not required for your care. Would you like to receive these texts? Please answer yes or no.”

Patient: “Yes.”

AGC staff: “Thank you. What mobile number should we text? [Staff repeat the number back and record the consent and date in the scheduling system.] You’ll receive a text from us confirming that you’re signed up.”

Exhibit — SMS consent section of the AGC patient intake form

Communication Preferences — Text Message (SMS) Consent

Advanced Gastroenterology Center (AGC) can send you appointment reminders, scheduling messages, procedure preparation instructions, and post-procedure follow-up by text. This is optional — check the box only if you want to receive these texts.

YES — I want to receive text messages. By checking this box and providing my mobile number below, I agree to receive appointment reminder, confirmation, scheduling, procedure preparation, and post-procedure follow-up text messages from Advanced Gastroenterology Center at the number I provide. These messages may include the type of appointment or procedure. Message frequency varies (typically 2 to 6 messages per appointment). Message and data rates may apply. Reply STOP to opt out, HELP for help. Consent is not a condition of treatment or of receiving any service.

Mobile number for texts

Patient / Guardian signature

Date

Leaving this box unchecked will not affect your care. You may opt out at any time by replying STOP to any message.

SMS Terms & Conditions: pavansachan.com/sms-terms-conditions Privacy Policy: pavansachan.com/privacy-policy

For office use only: Consent documented in scheduling system by ______________ Date __________

Disclosure shown to patients

By providing your mobile number, you agree to receive appointment reminder, confirmation, scheduling, procedure preparation, and post-procedure follow-up text messages from Advanced Gastroenterology Center, which may include the type of appointment or procedure. Message frequency varies (typically 2 to 6 messages per appointment). Message and data rates may apply. Reply STOP to opt out, HELP for help. Consent is not a condition of treatment.

Program details

Business: Advanced Gastroenterology Center (AGC)
Message types: Appointment reminders, confirmations, scheduling updates, procedure preparation instructions (such as diet and bowel-prep reminders), and a follow-up check-in after procedures. No marketing or promotional messages.
Frequency: Varies with your appointments — typically 2 to 6 messages per appointment, depending on the type of visit or procedure.
Confirmation: After you opt in, we send one text confirming your enrollment.
Message & data rates: May apply, depending on your carrier and plan.
Opt out: Reply STOP to any message at any time.
Get help: Reply HELP, or call (908) 688-8080.
Your information: Your mobile number and SMS consent are never sold or shared with third parties for their marketing.

Program policies

SMS Terms & Conditions Privacy Policy

How patients opt in to our text messages

Patient intake & registration form

When scheduling by phone or in person