Legal Documents

SMS Consent Language — Clinic Intake Form Snippet

Last Updated: March 30, 2026

Instructions for Clinics: Copy the consent block below onto your new client intake form, either paper or digital. The client must actively check the box or initial the line — pre-checked boxes do not constitute valid TCPA consent. Retain a copy of the signed form. Opt-in status must also be enabled in the client's PawPIMS record by a staff member after consent is obtained.

Text Message (SMS) Consent

I consent to receive appointment reminders, prescription pickup notices, post-visit care instructions, and other care-related text messages from [Clinic Name] at the mobile number I have provided.

  • Message frequency varies based on my appointment schedule and care needs.
  • Message and data rates may apply.
  • I may opt out at any time by replying STOP to any message.
  • Reply HELP for assistance.
  • For more information, visit pawpims.vet/legal/sms-terms/

☐ Yes, I agree to receive text messages from [Clinic Name].

Client Signature: _____ Date: _______

What to Submit to Twilio (Toll-Free Verification)

When completing Twilio's Toll-Free Verification form, use the following responses:

How do you collect opt-in consent?

Clients provide written consent on a signed new client intake form prior to receiving any SMS messages. The intake form includes explicit opt-in language, message frequency disclosure, message-and-data-rates notice, and STOP/HELP instructions. Consent is recorded in our practice management system (PawPIMS) per client record.

What is the opt-in language shown to end users?

Paste the consent block above.

How do you handle opt-outs?

Clients may reply STOP at any time. The PawPIMS system automatically processes STOP replies and blocks all further messages to that number. Opt-outs are tracked per client record and cannot be overridden by staff without renewed written consent from the client.

Proof of consent (what to upload):

Upload a PDF or screenshot of your intake form showing the consent block above, or submit a screenshot of the consent checkbox as it appears in a digital intake form.

Notes

  • One consent per number. If a client has multiple pets, a single consent covers all communications for that household at that number.
  • Do not pre-check the box. Regulators and carriers require affirmative opt-in. A pre-checked box is not valid consent under TCPA.
  • Paper forms: Scan and retain signed forms for a minimum of 4 years to cover the TCPA statute of limitations.
  • Digital forms: Your form software's submission record serves as consent documentation.