Recall SMS Consent Addendum

Purpose and scope

This addendum is a PHI-free starting point for participating healthcare practices that use Clickcase Technologies LLC's Recall service. It is intended for existing or prior patients who choose to receive recurring text messages from the practice and its authorized service providers.

An existing relationship, mobile number, or imported patient record does not by itself establish SMS consent. Clickcase sends only to records that the practice has marked with applicable consent and suppresses later STOP requests.

Suggested consent language

Copy and adapt the following language for the practice's own paper or digital patient-communication form. Keep the bracketed fields and message categories specific to the practice's workflow.

By providing my mobile number and selecting at least one option below, I authorize [Practice Name] and its authorized service providers to send me recurring text messages.

Please select each type of message you agree to receive:

[ ] Care and appointment messages: messages about appointments, care follow-up, and re-engagement related to my care.

[ ] Practice news, services, and offers (marketing): messages about practice news, services, and offers.

I understand that messages may be sent by the practice or an authorized service provider on the practice's behalf. Message frequency varies. Msg & data rates may apply. Consent is not a condition of care, treatment, or purchase. I can reply STOP at any time to opt out and HELP for help. I can contact [Practice Phone] with questions. The practice may share my mobile number and communication preferences with its authorized service providers solely to deliver and manage the selected messages under the practice's privacy practices and applicable agreements.

What the practice should record

The practice should identify itself on the final form, present it during intake, registration, or another documented patient-communication workflow, capture the mobile number and selected message categories, and retain the completed form or equivalent record.

If messages include both care or appointment follow-up and practice news, services, or offers, keep the selections distinct or clearly disclose both categories. Marketing messages should not be described as purely transactional messages.

Provider and agreement boundary

The template intentionally uses provider-neutral wording: the sender is the practice and its authorized service providers. Under the practice's applicable service and privacy agreements with Clickcase, Recall may process information and send messages on the practice's behalf.

A BAA or other service agreement may address permitted processing, but it does not replace the patient-facing SMS disclosure, consent selection, or the practice's record of consent.

Opt-out and help

Messages should identify the practice and its authorized service provider, include STOP instructions for opting out, and provide HELP instructions for assistance. Subsequent opt-out requests must be honored across future outreach unless the patient gives a new, valid consent through the practice's approved workflow.

Download and review

Download the blank SMS consent addendum PDF for practice review. It contains the same boilerplate language and blank fields; it does not contain patient information or create a consent record.

This template is not legal advice. Each practice should confirm the final disclosure, consent workflow, recordkeeping, and message categories with its own legal and privacy advisers. See the Recall Terms of Service and Recall Privacy Policy for Clickcase's public-site boundaries.