PATIENT COMMUNICATION CONSENT & OPT-IN AGREEMENT

1. PURPOSE OF COMMUNICATIONS

By signing this form, you consent to receive communications via email and SMS (text messaging) from Empleo Services, LLC dba Bluebird Solutions and its affiliates. These communications are transactional in nature, focused on provider and payor purposes (including billing notifications, account alerts, coordination of services and administrative updates). We do not use these channels for general marketing or promotional purposes.

2. SMS TERMS & CONDITIONS (TCPA/FCC COMPLIANCE)

• Message Frequency: The frequency of messages varies based on your care. You can expect to receive approximately 4 messages per month.
• Cost: Message and data rates may apply depending on your mobile carrier plan.
• Opt-Out: You may opt out of SMS communications at any time. Reply STOP to any message to unsubscribe. You will receive one final text confirming your opt-out. Support: Reply HELP to any message for assistance, call our office at 801.810.7192, or visit our website at https://getbluebirdsolutions.com/.

3. HIPAA & SECURITY LIABILITY WAIVER

Standard email and SMS text messaging are not encrypted methods of communication. While Bluebird Solutions maintains secure internal records, messages transmitted over public cellular or internet networks are at risk of being intercepted or read by unauthorized third parties.

• Acknowledgement: By consenting, you acknowledge these inherent security and privacy risks.
• Waiver: You waive any liability against Empleo Services, LLC (DBA Bluebird Solutions) or its affiliates and their contracted providers for any unauthorized access to your Protected Health Information (PHI) that occurs during the transmission of standard SMS or email messages. This waiver includes any liability for breaches of confidentiality resulting from the loss or theft of the device receiving the messages.

4. PRIVACY PROTECTION & THIRD-PARTY SHARING

Your privacy is our priority. Mobile information, opt-in data, and consent will not be shared with or sold to any third parties or affiliates for marketing or promotional purposes. Full privacy details are available at https://getbluebirdsolutions.com/privacy-policy/.