Hanaa Hanna, MD., Inc.

Pediatric Care You Can Trust in San Pedro, CA

Home About Dr. Hanna Our Services Forms Portal Contact Us

SMS Communication Consent

AT&T SMS Program Compliance Information

Program Name: Hanaa Hanna MD Pediatric Communications

Entity: Hanaa Hanna, MD., Inc. (Licensed Medical Practice)

Message Frequency: 2-4 messages per month (varies by appointment schedule)

Cost: Standard message & data rates may apply

Opt-Out: Reply STOP to cancel, HELP for assistance

Supported Carriers: AT&T, Verizon, T-Mobile, Sprint, Boost, Cricket, MetroPCS

Regulatory Compliance: TCPA, CTIA, HIPAA compliant

Contact: (310) 547-0888 | HanaaHannaMD@gmail.com

Important: This consent is required to receive text message (SMS) communications from our practice. By completing this form, you agree to receive automated messages as described below.

Patient Information

Last Name

First Name

Date of Birth

Mobile Phone Number

Standard message and data rates may apply. Check with your carrier.

SMS Consent Agreement

I consent to receive SMS messages from Hanaa Hanna, MD., Inc. as described in the AT&T Compliance Information above.

I have read and agree to the Privacy Policy & SMS Terms.

I understand that standard message and data rates may apply, and I am responsible for any charges from my carrier.

Electronic Signature

Electronic Signature

By typing your name, you are providing your legal electronic signature for SMS consent.

Date of Consent

Final Consent Acknowledgment: By submitting this form, you acknowledge that you have read, understand, and agree to all terms outlined above and in our Privacy Policy & SMS Terms. This consent is valid until revoked in writing.

← Back to Forms Portal 📄 View Full SMS Terms