TELEPHONE CONSUMER PROTECTION ACT PRIOR EXPRESS WRITTEN CONSENT FORM
Old Bridge Spine and Wellness Center, P.A. d/b/a NJ Spine and Wellness (“Company” or “Us”) seeks your consent to contact you (either directly, through service providers, and/or affiliates) with certain non-emergency, automated, autodialed, prerecorded, or other telemarketing phone calls and or text messages (SMS and MMS) under the Telephone Consumer Protection Act (TCPA). By signing this form, you authorize Us, our service providers, and our affiliates to contact you using:
- The phone and/or mobile number(s) listed below.
- An automatic telephone dialing system (ATDS) or artificial pre recorded voice.
PLEASE NOTE WE WILL NOT SELL YOUR CONTACT INFORMATION AND THIS CONSENT DOES NOT ALLOW THIRD-PARTIES TO CONTACT YOU ABOUT THEIR PRODUCTS OR SERVICES. ADDITIONALLY, PLEASE NOTE THAT THIS CONSENT ALLOWS US TO CONTACT YOU EVEN IF YOUR PHONE NUMBER IS CURRENTLY REGISTERED, OR IF IT IS LATER REGISTERED, ON ANY STATE AND/OR NATIONAL DO NOT CALL LIST.