Opt-In for Text Messages from Senior Services Plus, Inc. 
Text message notifications from Senior Services Plus, Inc. may include a reminder about an upcoming appointment, updates on a scheduled service you are scheduled to receive, reminders for an event you signed up for, etc. 
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First Name *
Last Name *
Date *
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Cell Phone Number *
By selecting "I Agree", you agree to receive recurring messages from Senior Services Plus, Inc. 

Reply STOP to any messages to opt out. 

Reply HELP for help. 

Message frequency varies. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. 
 *
Who is completing this form? 

If the person giving consent to text is completing this form please select "Self". 

If the person completing this form is an SSP staff person after receiving verbal consent, please select "SSP Staff"
 *
IF YOU ARE NOT STAFF, PLEASE SKIP THIS QUESTION. 

If SSP Staff completed this form, please list your first and last name below. 
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