Notification Consent Form

Notification Consent Form

This Notification Consent Form is entered into between Organization Name: (the "Organization") and Client Name: (the "Consenting Party").

RECITALS

WHEREAS, the Organization provides communications to individuals and requires the express consent of the Consenting Party to deliver notifications by certain channels; and

WHEREAS, the Consenting Party wishes to receive notifications from the Organization in accordance with the preferences and conditions set forth in this form.

CONSENT

The Consenting Party hereby authorizes the Organization to deliver notifications concerning the matters identified in this form to the contact channels and under the conditions specified below. This Consent does not waive any rights of the Consenting Party except as expressly provided herein.

NOTIFICATION METHODS AND PREFERENCES

The Consenting Party elects the following notification channels (check all that apply):

Email notifications    SMS/text messages    Automated or live phone calls    Voicemail messages    Postal mail    Third-party/emergency contact

By selecting SMS/text message notifications, the Consenting Party expressly consents to receive automated and/or prerecorded messages from the Organization. Carrier message and data rates may apply. The Consenting Party remains responsible for fees imposed by the mobile carrier.

SCOPE OF NOTIFICATIONS

NOTIFICATION SCHEDULE AND RESTRICTIONS

Preferred cadence (check all that apply):

Immediate/real-time notifications    Daily summary    Weekly summary

From:    To:

EFFECTIVE PERIOD AND REVOCATION

This Consent is effective beginning on Effective Date: and will remain in effect until Expiration Date: unless earlier revoked in accordance with the procedure below.

DATA USE AND CONFIDENTIALITY

The Organization will use contact information provided herein solely for the purpose of delivering notifications as authorized by the Consenting Party and as necessary to administer such notifications. The Organization will apply reasonable administrative, technical and physical safeguards to protect contact information from unauthorized access, consistent with industry practice.

The Organization may disclose contact information to third parties only to the extent necessary to deliver notifications (for example, service providers that transmit messages) or as required by law. The Organization shall require such third parties to adhere to confidentiality and data-protection obligations consistent with this form.

LIMITATION OF LIABILITY

The Organization shall use commercially reasonable efforts to deliver notifications in accordance with the Consenting Party's preferences but does not guarantee delivery times, content integrity, or error-free transmission. The Organization is not liable for delays, failures, or errors caused by service providers, carriers, or the Consenting Party's failure to maintain accurate contact information.

GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

This Notification Consent Form will be governed by and construed in accordance with the laws of the state or jurisdiction of Organization's principal office as set forth by the Organization. If any provision of this Form is held invalid or unenforceable, the remaining provisions will continue in full force and effect. This Form constitutes the entire agreement between the parties with respect to notification consent and supersedes prior oral or written communications on the same subject.

ACKNOWLEDGMENT AND CERTIFICATION

The Consenting Party certifies that the contact information provided is accurate and that all choices indicated above are the Consenting Party's free and informed elections. The Consenting Party acknowledges receipt of a copy of this form upon signing and understands the procedures for revocation.

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