Mira Mace Patient Consent Form Preview
This page shows a screenshot of the form where patients opt in to receive care-related messages from Mira Mace.
In this form, patients enter their phone number and must check an unchecked, required checkbox labeled:
"I agree to receive care-related text messages and phone calls from Mira Mace. Message & data rates may apply."
Consent is not pre-selected and is required before any communication is sent.