Patient Referral Form

Last Updated: November 11, 2025

Excell Home Health Plus uses SMS (text messaging) to communicate efficiently with individuals, including clients, caregivers, and visitors. By providing your phone number and agreeing to receive SMS messages, you consent to these Terms and Conditions. The following terms explain how we manage SMS communication and your rights related to receiving text messages.

  1. Consent to Receive SMS Messages

    By providing your phone number and consenting to receive text messages from us, you authorize Excell Home Health Plus to send SMS messages to the phone number you provided.

    No mobile opt-in, SMS consent, or phone numbers will be shared or sold to any third party or affiliate for marketing or promotional purposes. All information collected through SMS communication is kept confidential and used solely to provide requested services or respond to direct inquiries. We take appropriate measures to protect your data and ensure it remains secure.

  2. How to Opt In (Opt-In Language)

    By submitting an online form and providing your phone number, you may see a statement such as:

    • “[] By checking this box, you consent to receive SMS messages from Excell Home Health Plus related to your care and services. These may include appointment reminders and confirmations, care plan or follow-up instructions, scheduling and rescheduling notifications, visit updates, responses to service or care inquiries, important health or safety notifications, general administrative messages related to your care, and updates about our service offerings. Message frequency may vary depending on your care needs or inquiry type. Message and data rates may apply. Reply STOP at any time to opt out, or HELP for assistance. ”

  3. Types of SMS You May Receive

    If you have consented to receive text messages, you may receive messages such as:

    • Appointment reminders and confirmations
    • Care plan or follow-up instructions
    • Scheduling and rescheduling notifications
    • Visit updates
    • Responses to service or care inquiries
    • Important health or safety notifications
    • General administrative messages related to your care
    • Updates about our service offerings

  4. Message Frequency and Fees

    The number of messages you receive will depend on your interactions with Excell Home Health Plus and may vary from 1–4 messages per week (or more during active care, service coordination, or follow-up periods).

    Standard text messaging and data rates may apply based on your mobile carrier plan. We are not responsible for any charges billed to you by your mobile provider.

  5. How to Opt Out

    You can stop receiving text messages from us at any time by:

    • Replying STOP to any message (this will unsubscribe you from all future messages)
    • Contacting us directly at 708-867-0400 and requesting removal from our SMS list
    • Choosing not to check the SMS consent box on any of our online or paper forms

    After opting out, you may receive a confirmation message stating that you have been unsubscribed.

  6. Need Help with SMS?

    Reply HELP to any of our messages for assistance. You will receive a message with further contact information:

  7. Privacy and Data Use

    Your privacy is important to us. All information collected for SMS communications is subject to our Privacy Policy, which can be viewed on our website.

  8. Additional Options

    If you do not wish to receive SMS messages, you may choose not to check the SMS consent box on our forms. You can still communicate with us via phone or email at 708-867-0400 or excellhhplus@gmail.com.