Guide · Opt-in

10DLC Opt-In Examples — Web Forms, QR Codes, Paper Forms, Verbal Consent

TCR and US carriers require provable consent for every recipient. Below are paste-ready opt-in examples for each channel, with the screenshots and disclosures reviewers expect.

Web form — checkbox + CTA

The checkbox must default to unchecked. The CTA next to it must identify the sending brand, the message types, frequency, rate language, and STOP/HELP behavior.

Compliant CTA

[ ] Yes, I agree to receive appointment reminders and promotional offers from Acme Health (up to 4 msgs/month). Msg & data rates may apply. Reply STOP to unsubscribe, HELP for help. By checking this box, I agree to the SMS terms in the Privacy Policy.

Screenshots reviewers expect

• The live form with the checkbox visible and unchecked.
• The privacy policy page with the SMS section visible.
• A successful submission state, if your form has multiple steps.

QR code — printed material

QR codes need a clearly disclosed landing page. The page must include the same elements as a web form CTA. The print material itself should not be the only consent surface.

Landing page CTA

Subscribe to Acme Cafe SMS perks. By submitting, you agree to receive promotional messages from Acme Cafe (up to 6 msgs/month). Msg & data rates may apply. Reply STOP to unsubscribe, HELP for help. Privacy policy: acmecafe.com/privacy

Paper form

Paper forms must include the same disclosures as a web form. Carriers expect a clear signature or initials line near the SMS section.

Compliant paper CTA

SMS Notifications (optional)
[ ] I authorize Acme Clinic to send me appointment reminders by SMS to the mobile number above. Up to 4 msgs/month. Msg & data rates may apply. Reply STOP to unsubscribe, HELP for help. Acme Clinic does not share mobile information with third parties for marketing.

Initials: ____  Date: ________

Verbal opt-in

For phone-based intake, staff must read a script that captures the same elements. Record the date/time and a confirmation SMS to close the loop.

Compliant verbal script

To set up SMS reminders for your appointments, I'll need your verbal consent. Acme Clinic will send up to 4 messages per month with reminders and account alerts. Msg & data rates may apply. You can reply STOP to unsubscribe at any time. Do you authorize Acme Clinic to send these SMS messages to {phone}?
[Confirm verbally, log timestamp, send confirmation SMS asking to text Y to confirm.]

In-app opt-in

Mobile or web app opt-in screens follow the same rules. The toggle/checkbox must default to off, and the consent text must be readable on the same screen as the toggle.

Pre-checked checkboxes are non-compliant

Reviewers will reject any flow where the consent checkbox is pre-checked, hidden inside a terms-of-service blanket, or buried in a multi-purpose notice.