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Coronavirus SMS Campaign: Consent Form
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* Required
Email
*
Your email
Please complete the once off registration and consent form below in order for us to set up your automated SMS Campaigns and send to your customers on behalf of your Pharmacy.
*
I hereby give consent. Let's get started!
Required
Your Name:
*
Your answer
Pharmacy Name:
*
Your answer
Pharmacy BHF / Practice Number:
*
Your answer
Pharmacy Contact Number:
*
Your answer
Pharmacy WhatsApp Number
Another way to communicate with your Patients. If you need assistance, contact us.
Your answer
Pharmacy Email Address:
*
Your answer
Please select the LIST OF PATIENTS you would like to SMS
*
Choose
All Patients
Last 3 Months Patients / Customers
Last 6 Months Patients / Customers
Last 3 Months Repeats Patients
Last 6 Months Repeats Patients
Last Months Repeats Patients
I'd like to choose the following Message Options:
*
Short SMS Options are 20 Cents per Credit Per Patient. Long SMS Options are 40 Cents per Credit Per Patient. - All excluding VAT.
Short SMS Option #1
Short SMS Option #2
Short SMS Option #3
Short SMS Option #4
Long SMS Option #1
Long SMS Option #2
Long SMS Option #3
Long SMS Option #4
Once-off (Long SMS with Trading Hours, WhatsApp No., Phone No. & Email Address )
Other:
Required
What do you think about this service for your Pharmacy?
It's great, thank you!
Other:
A copy of your responses will be emailed to the address you provided.
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