SMS & EMAIL MARKETING OPT-IN 

Consent to Receive Communications

By providing your mobile number and/or email address, you consent to receive appointment reminders, follow-ups, and promotional communications from Revive Active and Aesthetic PLLC.

Promotional communications may include special offers, service updates, and event invitations.

You may opt out at any time by:

  • Replying “STOP” to any SMS message

  • Clicking “Unsubscribe” at the bottom of promotional emails

Yes, I agree to receive promotional emails and SMS from Revive Active and Aesthetic PLLC. I understand I can opt out at any time.

COOKIE CONSENT BANNER TEXT

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We use cookies to enhance your experience, analyze site traffic, and serve personalized content and ads. By clicking “Accept All,” you consent to our use of cookies in accordance with our [Cookie Policy].

You can manage your cookie preferences at any time.

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Make sure to link your full Cookie Policy and ensure user preferences are respected.

HIPAA NOTICE ACKNOWLEDGMENT CLAUSE

For Intake Forms or Online Registration:

By signing or submitting this form, I acknowledge that I have received and reviewed the Notice of Privacy Practices for Michel Harrington PLLC/Revive Active and Aesthetic PLLC, which outlines how my protected health information (PHI) may be used or disclosed and describes my rights under HIPAA.

Yes, I have received and reviewed the HIPAA Notice of Privacy Practices.