Text Message Consent Form Template (Required Language)
The short answer: a compliant text message consent form must clearly disclose who is sending the messages, what kinds of messages the subscriber will receive, roughly how often, that message and data rates may apply, how to opt out (STOP) and get help (HELP), that consent is not a condition of purchase or service, and where to find your terms and privacy policy. Those elements are the disclosure elements the FCC's implementing rules (47 CFR 64.1200) describe for the "prior express written consent" the TCPA (47 U.S.C. 227) requires for marketing texts. Whether a given form meets the standard depends on your program and jurisdiction, so have counsel review your final language. This article gives you a copy-ready template and explains each required clause.
Why the Consent Form Language Matters
Under the TCPA, sending marketing text messages without the right level of consent exposes the sender to statutory damages of $500 per violation, and up to $1,500 per willful violation. Each individual text can count as a separate violation, so the exposure compounds quickly across a subscriber list. Critically, the burden of proving consent falls on the sender, not the recipient. If you cannot produce a record showing what the person agreed to and when, courts and regulators generally treat the consent as if it never existed.
Beyond the statute itself, the CTIA Messaging Principles and Best Practices set the expectations that US wireless carriers enforce through the 10DLC registration system. Campaigns whose opt-in flows do not show clear disclosure language are routinely rejected or suspended by carriers, even when no lawsuit is ever filed. In practice, your consent form has two audiences: the courts (TCPA) and the carriers (CTIA). The template below is written with both audiences in mind.
If you are unsure which tier of consent your messages need in the first place, start with our guide to express consent versus express written consent. Informational and transactional messages need a lower tier of consent than marketing messages, but the disclosure elements below are considered best practice for every program type.
Copy-Ready Consent Form Template
Place the following language directly above or beside the phone number field and checkbox on your web form. Replace the bracketed items with your organization's details. The checkbox must be unchecked by default, and the subscriber must take an affirmative action (checking the box or signing) to agree.
[ ] Yes, I agree to receive text messages from [Organization Name].
By checking this box and submitting this form, I provide my electronic signature and expressly consent to receive recurring [type of messages: e.g., appointment reminders, donation updates, program alerts, and promotional messages] from [Organization Name] at the mobile number I provided. Message frequency varies [or: up to X messages per month]. Message and data rates may apply. Consent is not a condition of any purchase, donation, or service. Reply STOP to cancel at any time. Reply HELP for help or contact [support email or phone number]. View our Terms of Service at [URL] and Privacy Policy at [URL].
That single paragraph, paired with an affirmative checkbox and a stored record of the submission, is written to address the written-consent disclosure elements the FCC's rules describe and the program details carriers review during 10DLC campaign vetting.
Every Required Clause, Explained
The table below breaks the template into its component clauses, identifies where each requirement comes from, and flags common drafting mistakes.
| Clause | Source of the Requirement | Common Mistake |
|---|---|---|
| Identity of the sender ("from [Organization Name]") | TCPA disclosure principles; CTIA Messaging Principles | Naming a parent brand or vendor instead of the name that will appear in the messages |
| Description of message types and program purpose | FCC rules on the scope of consent (47 CFR 64.1200) | Vague language like "messages from us" that does not match what is actually sent |
| Message frequency ("Message frequency varies" or a number) | CTIA Messaging Principles and carrier vetting standards | Omitting frequency entirely, a frequent cause of campaign rejection |
| "Message and data rates may apply" | CTIA Messaging Principles | Burying the phrase in a linked document instead of the form itself |
| Not a condition of purchase or service | FCC written-consent rules for marketing messages | Requiring SMS opt-in to complete a purchase, donation, or registration |
| STOP opt-out instruction | FCC revocation rules; CTIA Messaging Principles | Only offering an email or phone opt-out and not honoring reply STOP |
| HELP instruction with contact info | CTIA Messaging Principles | No HELP keyword configured, so replies go unanswered |
| Links to terms and privacy policy | Carrier and registry (10DLC) program requirements | Linking to a privacy policy that says nothing about SMS data sharing |
| Electronic signature or affirmative action | TCPA written-consent standard, which accepts E-SIGN electronic signatures | Pre-checked boxes or consent buried in general terms of service |
What About Autodialer Language?
Older consent templates often included a sentence stating the subscriber agrees to receive messages "sent using an automatic telephone dialing system." After the Supreme Court's decision in Facebook v. Duguid narrowed what counts as an autodialer under the TCPA, that specific phrase is no longer the load-bearing element it once was. Whether a particular platform falls inside the narrowed autodialer definition is a fact-specific question.
That does not mean consent stopped mattering. The scope of consent still controls what you may send: a person who agreed to appointment reminders has not agreed to fundraising appeals, and the FCC's rules still require prior express written consent for marketing messages regardless of the dialing technology. The safer drafting approach today is to describe the message program accurately and broadly enough to cover everything you intend to send, rather than leaning on autodialer boilerplate. If your program spans multiple message types, list them.
Adapting the Template for Paper Forms and Keyword Opt-Ins
The same disclosure elements apply regardless of the capture channel; only the mechanics change.
- Paper forms: Print the full disclosure paragraph above the signature line. The physical signature serves as the written consent. Scan and store the form; a filing cabinet is a valid consent database only if you can actually retrieve the page later.
- Keyword opt-ins: When someone texts a keyword like JOIN to your number, your advertising for the keyword (poster, slide, social post) should carry the disclosure language, and your auto-reply confirmation message should restate the program name, frequency, "message and data rates may apply," and STOP and HELP instructions. See real-world examples in our roundup of SMS opt-in message examples.
- Verbal capture (phone or front desk): Read a script containing the same elements and record the agreement in your system with a timestamp, the script version, and the staff member's name. For marketing programs, follow up with a confirmation text or a written form, since verbal agreement alone does not meet the written-consent standard.
Storing the Proof
A consent form is only as useful as the record it creates. For every opt-in, store the phone number, the date and time, the exact disclosure language displayed (version-controlled), the capture source (which form, which keyword, which event), and the IP address or signature image where applicable. Because the sender bears the burden of proof and TCPA claims can reach back four years, plan to retain these records for at least four years after the subscriber's last message or opt-out. Keep opt-out records indefinitely; you need them to prove you honored a STOP request.
This article is general information, not legal advice. Requirements vary by jurisdiction and change over time, so confirm your own obligations with qualified counsel or the relevant regulator.
Frequently Asked Questions
What must a text message consent form include?
A compliant form includes the sender's name, a description of the message program, message frequency, the phrase "message and data rates may apply," STOP and HELP instructions, a statement that consent is not a condition of purchase, links to your terms and privacy policy, and an affirmative action such as an unchecked checkbox or signature.
Is a pre-checked checkbox valid TCPA consent?
No. Prior express written consent requires a clear, affirmative act by the subscriber. A box that is checked by default does not demonstrate that the person knowingly agreed, and carriers reviewing your opt-in flow during 10DLC vetting treat pre-checked boxes as a defect.
Do I need written consent for appointment reminders?
Purely informational messages such as appointment reminders generally require prior express consent, a lower tier than the written consent required for marketing. Providing a phone number in a transaction context can establish express consent for related informational texts. If reminders will ever include promotional content, obtain express written consent using the template above.
Does an online form count as "written" consent?
Yes. The TCPA written-consent standard accepts electronic signatures consistent with the federal E-SIGN Act, so a checkbox plus form submission qualifies when the required disclosures are presented and you retain a record of the event.
How long should I keep SMS consent forms?
Keep consent records at least four years after the last message to that subscriber, matching the four-year federal catch-all statute of limitations that courts apply to TCPA claims. Many organizations keep them longer, and opt-out records should be kept permanently.
Build Disclosure-Ready Opt-In Flows
FRANSiS bakes the consent workflow into the platform: disclosure-ready web forms, keyword opt-ins with automatic confirmation messages, timestamped consent records for every subscriber, and automatic STOP and HELP handling, with an AI Powered Helper that answers subscriber replies conversationally while keeping your program inside carrier guidelines. Contact us to see it in action.
