SMS Opt-In Web Form Demonstration

How This Opt-In Works

ShrinkDocs™ is a HIPAA-compliant patient management platform operated by Trinity Counseling Center, LLC (815 E Jackson Street, Medford, OR 97504). Healthcare providers invite patients to complete an online intake form through a secure Patient Portal.

During this intake process, patients enter their phone number in the form fields and are then presented with consent options. The SMS consent checkbox is completely optional and separate from the required service consent. It is unchecked by default and patients can submit the intake form and receive full care without opting in to SMS. Only patients who affirmatively check the SMS box will receive text messages at the phone number they provided. SMS consent is never a condition of receiving treatment or using ShrinkDocs™.

▼ Live Form Replica — Exactly As Patients See It ▼

Patient Intake Form

ℹ️ Below is a simplified replica of the patient intake form. The actual form collects additional clinical information.

First Name *

Last Name *

Date of Birth *

Email *

📱 Phone Number *

↑ This is the number that will receive SMS if the patient opts in below

Emergency Contact

Address

[ Additional clinical fields: Medical History, Current Medications, etc. ]

OPTIONAL — Not required to receive care or use ShrinkDocs

SMS Program Compliance Details

Opt-In Method

Web form checkbox within the ShrinkDocs™ Patient Portal intake form. Checkbox is unchecked by default, clearly labeled as OPTIONAL, and visually separated from required service consent. SMS consent is not a condition of receiving care.

Message Types

Appointment reminders, session feedback requests, and care-related communications. No marketing or promotional content.

Message Frequency

Approximately 1–4 messages per month, based on patient's appointment schedule.

Opt-Out

Reply STOP to any message, or update preferences in the Patient Portal. Reply HELP for assistance or call (855) 513-8835.

Costs

Message and data rates may apply per the patient's mobile carrier plan.

Business Identity

Trinity Counseling Center, LLC (DBA ShrinkDocs™), 815 E Jackson St, Medford, OR 97504

⚠️ Toll-Free Verification — Opt-In Web Form Demonstration

SMS Opt-In Web Form — Verification Demonstration