<p><b><u>10. CELL PHONES:</u></b>
I hereby consent to provide my telephone number(s), including my wireless telephone number(s), so that
representatives from the Clinic, its successors or assigns can contact me in any manner including but not limited
to by manually placing a call, by using an automatic telephone dialing system or an artificial or prerecorded
voice, by texting, or by e-mailing, regarding any matter, including but not limited to my medical treatment,
prescriptions, scheduling, billing or collection matters. This consent includes any updated or additional contact
information that I may provide. I understand that I will be able to change my preference at any time.</p><p><br><u><b>11. VIDEOTAPING/RECORDING:</b></u>
I understand and agree not to photograph, videotape, audiotape, record or otherwise capture imaging or sound on
any device. I also understand it is my responsibility to assure those accompanying me comply with this requirement.</p>