SMS OPTIN and OUT

NAME (Please Print) *

Date *

Message frequency varies, and additional mobile messages may be sent periodically based on your interaction with Attending Home Care. Attending Home Care reserves the right to alter the frequency of messages sent at any time to increase or decrease the total number of sent messages. Attending Home Care also reserves the right to change the short code or phone number where messages are sent.

Message and data rates may apply. If you have any questions about your text plan or data plan, it is best to contact your wireless provider. Your wireless provider is not liable for delayed or undelivered messages.

You can choose to OPT IN or OPT OUT using this form.

You can also choose to OPT IN by texting START to 209-488-8212.

You can OPT OUT by texting STOP to the ten-digit long code from which the text messages are being sent.

If you need help you can text HELP to to 209-488-8212.

I accept and DO want to receive text messages. (Please confirm cell phone number and sign below.) I decline and DO NOT want to receive text messages. (Please sign below.)

Cell Phone # (Without country code – Ex: 718-555-1212)* Is this your primary phone? * Yes No

What is 11 + 85?

Employee Signature: *

Your request has been submitted successfully!!