SMS Consent & Disclosure

SMS Consent & Disclosure

(TCPA + Carrier Compliance)
By providing your mobile number and opting in, you consent to receive HIPAA-compliant text messages from Virtucare Harmony.
Purpose of Messaging
Text messages may be used for
Message Frequency
Message frequency may vary based on your care needs, appointments, and communication preferences.
Message & Data Rates
Message and data rates may apply.
Opt-Out / Help

SMS Consent & Disclosure

(TCPA + Carrier Compliance)

By providing your mobile number and opting in, you consent to receive HIPAA-compliant text messages from Virtucare Harmony.

Purpose of Messaging

Text messages may be used for:

Text messaging is not used for medical emergencies.

Message Frequency

Message frequency may vary based on your care needs, appointments, and communication preferences.

Message & Data Rates

Message and data rates may apply.

Opt-Out / Help

Opting out will stop all SMS communications unless you re-enroll.

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Referral Submitted Successfully

Thank you for submitting a referral to VirtuCare Harmony.

We have received your referral request, and our team will review the information provided. A member of our team will be in touch regarding the next steps.

If you would like to fax the patient’s face sheet or additional referral documents, please fax them to:

Fax: (949) 890-1095

Thank you for choosing VirtuCare Harmony.

Referral & Intake Form

Patient Information
Referral Details
By submitting this form, you are requesting that VirtuCare Harmony contact the patient regarding services. Submission does not guarantee acceptance or an appointment.