10DLC-Compliant Privacy Policy & Terms Template
Retail Healthcare Practices (Chiropractors, Dentists, Optometrists)
PRIVACY POLICY TEMPLATE
Effective Date: [Insert Date]
Practice Name: [Full Legal Practice Name]
Website: [Website URL]
Phone: [Practice Phone Number]
Email: [Contact Email]
Introduction
We are committed to protecting your privacy and safeguarding your personal information. This
policy explains how we collect, use, store, and protect your information.
Information We Collect
We may collect name, address, email, phone number, health information necessary for treatment,
insurance information, and appointment details.
How We Use Your Information
We use your information to provide healthcare services, manage appointments, communicate with
you, process billing, and comply with legal requirements.
SMS Messaging & Mobile Information
If you opt in to SMS communications, we may send appointment reminders, scheduling updates,
limited appointment-related information, and review requests.
Message frequency may vary. Message and data rates may apply.
Reply STOP to opt out. Reply HELP for assistance.
Your mobile phone number and SMS consent will NOT be shared, sold, rented, or disclosed to third
parties for marketing or promotional purposes.
Data Protection
We implement administrative, technical, and physical safeguards to protect your information.
Information Sharing
We do not sell patient information. Information may be shared only as required by law or to support
healthcare operations.
Your Rights
You may request access to your information or withdraw SMS consent at any time.
Contact Information
Contact us at [Practice Phone Number] or [Practice Email Address].
TERMS & CONDITIONS TEMPLATE
Effective Date: [Insert Date]
Practice Name: [Full Legal Practice Name]
Acceptance of Terms
By using our services or opting into SMS communications, you agree to these Terms & Conditions.
Healthcare Disclaimer
Information provided via SMS is for appointment-related communication only and is not medical
advice. In an emergency, call 911.
SMS Messaging Terms
By opting in, you agree to receive appointment reminders, scheduling updates, limited
appointment-related communications, and review requests.
Message Frequency
Message frequency may vary based on appointment activity.
Message & Data Rates
Message and data rates may apply based on your carrier plan.
Opt-Out Instructions
Reply STOP to opt out at any time.
Help Instructions
Reply HELP for assistance or contact us at [Practice Phone Number].
Consent Not Required for Treatment
Consent to receive SMS messages is not a condition of receiving healthcare services.
Privacy
Your use of services is also governed by our Privacy Policy. We do not sell or share mobile
numbers for marketing purposes.
Limitation of Liability
We are not liable for carrier delays or technical transmission failures.
Contact Information
For questions, contact [Practice Name] at [Phone Number] or [Email Address]