Client Onboarding and Communication Agreement

Last Updated: April 8, 2026

Welcome to The Selene Platform. This Agreement explains how the Platform supports communication, continuity, reminders, and care coordination, and how you can choose what types of communication you want to receive.

1. Purpose

The Platform is designed to support day-to-day continuity, structure, reminders, journaling, accountability, and communication. It may also support collaboration with an authorized therapist, clinician, caregiver, coach, or other support contact you choose.

The Platform is not emergency response and is not a substitute for direct medical or mental health care.

2. Authorized Support Contacts

You may authorize the Platform to coordinate relevant communications with one or more support contacts.

Authorized Contact Name: ____________________

Role / Relationship: ____________________

Email: ____________________

Phone: ____________________

By submitting this information, you confirm that you are authorized to provide it.

3. What Coordination May Include

If you authorize coordination, the Platform may help with reminders and check-ins, task and scheduling prompts, summaries and updates, therapist or caregiver guidance, red-flag or escalation alerts, and communication needed to support continuity and follow-through.

4. SMS Opt-In

By checking the box below and providing your mobile number, you agree to receive text messages from The Selene Platform related to your use of the Platform.

These messages may include onboarding messages, reminders, scheduling prompts, account notices, care-coordination messages, and red-flag or escalation alerts.

Message frequency varies.
Message and data rates may apply.
Reply STOP to opt out.
Reply HELP for help.

☐ I agree to receive SMS text messages from The Selene Platform.

Mobile Number: ____________________

☐ I agree to receive non-essential informational text messages about platform updates and helpful features.

5. Email Opt-In

By checking the box below and providing your email address, you agree to receive email communications related to your account and use of the Platform.

These emails may include onboarding materials, reminders, summaries, care-coordination messages, account notices, and service updates.

☐ I agree to receive email communications from The Selene Platform.

Email Address: ____________________

☐ I agree to receive optional newsletters, educational content, and product updates by email.

6. Consent to Care Coordination

☐ I authorize The Selene Platform to coordinate relevant support communications with the support contact(s) I have designated, consistent with my permissions and applicable law.

7. Changes to Consent

You may withdraw SMS consent at any time by replying STOP. You may unsubscribe from optional marketing emails at any time through the unsubscribe link. You may request changes to your preferences or authorized contacts by contacting [Support Email].

8. Acknowledgment

By signing or submitting this Agreement, you acknowledge that you have read and agree to:

Terms & Conditions
Privacy Policy

9. Signature

Client Signature: ____________________

Printed Name: ____________________

Date: ____________________

Representative Name (if applicable): ____________________

Relationship: ____________________

Representative Signature: ____________________

Representative Date: ____________________