Prescription Message Service Authorisation Consent Form Note: * indicates required information.Name* Prefix MrMrsMissMsDrProf.Rev. First Last Date of Birth* Day Month Year Address* Street Address City ZIP / Postal Code Mobile Phone Number*Name of account holder for mobile phoneI confirm this is my own personal mobile phone and understand that I cannot receive messages regarding prescriptions for a family member.Agreement* McPhersons Pharmacy may send SMS notifications about your prescriptions, including when they’re ready for collection. Your phone number and prescription details will never be shared with anyone outside the pharmacy, and medication specifics are not included in the messages. These texts are solely for prescription-related communication and not for marketing. Please note, there’s no option to reply to these texts directly. I consent to McPhersons Pharmacy contacting me by text for the reasons mentioned. I will notify the pharmacy if my mobile number changes. I understand texts are sent securely but may be transmitted over a public network to my personal, potentially unsecured phone. For data protection, only personal mobile numbers can be used for registration.CAPTCHANameThis field is for validation purposes and should be left unchanged.