Electronic communication offers patients, family members, and other identified authorized individuals the opportunity to communicate with MPC staff by email/text messaging for non-urgent matters. This form provides information about the risks of email/text messaging and guidelines for both.

Potential Risks of Email Correspondence

Electronic communication has a number of risks which include, but are not limited to, the following:

• Email/text messages can be circulated, forwarded, printed and stored in paper and electronic files.

• Back-up copies of email / text messages may exist, even after the sender or the recipient has deleted his/her copy.

• Email/text messages delivery is not guaranteed.

• Email/text messages can be received by unintended recipients.

• Email/text messages can be intercepted, altered, forwarded, or used without authorization or detection.

• Email can be used to introduce viruses into computer systems.

• Email/text messages are easier to forge than handwritten or signed papers.

• Email/text message service providers (i.e., Verizon, AOL, Yahoo, etc.) have a right to archive and inspect emails / text messages sent through their systems.

• Email can be used for phishing, a technique of obtaining sensitive personal information from individuals by pretending to be a trusted sender.

• The use of open internet channels is not secure or encrypted – meaning that email and/or text messages between individuals could potentially be viewed by an unauthorized person who might intercept or read those messages.

You should not communicate through email or text messages with MPC clinical and administrative staff if any of the above risks concern you.

Email / text message communication:

• Should be used to enhance the relationship between the person served and the service provider.

• Must never replace in-person or telehealth contacts that are the very basis of the relationship between the patient and the service provider.

• Is not an appropriate method for sharing urgent or emergency/crisis information. If you experience a mental health medical emergency or crisis, call 911 or go immediately to the closest emergency room.

Guidelines for email communication:

• Include the general topic of your message in the Subject Line of the email (i.e. Appointment).

• The content of the email should only be used for non-urgent issues.

• The email message should not be time sensitive.

• Inform MPC of changes to your email address.

Guidelines for text messaging:

• The content of the text should only be used for non-urgent issues.

• The text message cannot be time sensitive.

• Inform MPC of changes to your cell phone number.

I understand that if I choose to sign this form, I consent to email/text message communication between MPC staff. The email address below will be documented in my electronic health record. Additionally, all email correspondence will be documented in my Electronic Health Record.