Text Messaging Opt-In Consent Form

Business Name: Darryn L Duchon, Attorney

Address: 8445 Keystone Crossing, Suite 125, Indianapolis, IN 46240

Phone: 317-685-3970

Email: dlduchon@aol.com

By signing this form, you consent to receive SMS/text messages from Buck Duchon for purposes including, but not limited to:

• Appointment reminders
• Service updates
• Meeting confirmations
• Client support

Message Frequency: Message frequency will vary depending on your texting me and I will only text you in response to your texting me.

Charges: Standard message and data rates may apply depending on your mobile carrier.

Opt-Out: You may opt-out at any time by replying STOP to a text message you receive from us. For help, reply HELP or contact us directly at 317-685-3970 or [insert email].

Privacy: Your mobile information will not be shared with third parties or affiliates for marketing or promotional purposes. For details, please review our Privacy Policy.

I understand and agree to the following:

• I am voluntarily providing my mobile phone number.
• I consent to receive SMS/text messages from Buck Duchon.
• I understand I can withdraw my consent at any time by replying STOP or contacting Buck Duchon.
• I have read and agree to the Privacy Policy and Terms outlined above.

Client Name (Print):

Mobile Phone Number:

Signature:

Date: