This Paperwork is ONLY for Existing Patients wanting to Re-Establish with our office.
NEW PATIENTS have to obtain their paperwork via the Webstore.
PDF FORMAT.
Existing Patient
ENHANCED WELLNESS OF OAK GROVE
56 98th Place Blvd, Hattiesburg, MS 39402 ~ Ph: 601-264-7286 ~ Fax1: 601-450-4640 ~ Fax2: 888-561-1290
DISCLAIMER:
By starting a text conversation with EWOG-ENHANCED WELLNESS OF OAK GROVE PLLC by texting (601) 450-0953, You agree to receive informational messages (appointment reminders, account notifications, etc.) from EWOG. I, the patient, hereby consent and state my preference to have my provider, [Laurie Ryba, Nurse Practitioner], and other staff at [EWOG-Enhanced Wellness of Oak Grove PLLC] communicate with me by email or standard SMS messaging regarding various aspects of my medical care, which may include, but shall not be limited to, test results, prescriptions, appointments, and billing. I understand that email and standard SMS messaging are not confidential methods of communication and may be insecure. I further understand that, because of this, there is a risk that email and standard SMS messaging regarding my medical care might be intercepted and read by a third party. I have reviewed and accept EWOG [Enhanced Wellness of Oak Grove PLLC]'s TERMS/CONDITIONS/PRIVACY POLICY. Contact us at 601-264-7286 or 601-450-0953 for questions or concerns. Privacy Policy and Terms [https://www.enhancedwellnessog.com/sms]. Consent is not a condition of purchase. Msg and data rates may apply. Msg frequency varies. For help, reply HELP, call 601-264-7286, call/text 601-450-0953, or contact via website https://www.enhancedwellnessog.com.
OPT-OUT
out at any time by replying
STOP
and you will receive no further messages. To OPT-IN to receive messages from us, please text
START
to
601-450-0953
CLINIC HOURS (Lunch 12-1:30PM)
- Mon, Tue, Thu
- -
- Wednesday
- -
- Fri - Sun
- Closed