I understand that Origins will collect, store, and use my personal health information (PHI) to provide care and services. I acknowledge that my information will be handled in accordance with HIPAA privacy and security standards, and that I have rights regarding how my health information is used and shared.

I consent to receive care-related communications from Origins, including appointment reminders, treatment updates, and relevant educational or wellness information, via phone, email, or text. I understand that I may opt out of non-essential communications at any time by replying STOP.