Remote Client Services and Text Notifications

Privacy Policy for Remote Client Services

Second Chance, Inc. will provide Remote Client Services (Telehealth) utilizing the Zoom Virtual Meeting Platform. Some personal information such as your name, email address, and computer IP address will be shared with Zoom. Additionally, some meetings may be recorded and uploaded to a cloud for documentation of session completion. To participate in Zoom meetings, you must read and agree to Zoom's Privacy Policy.

Second Chance, Inc. will continue to maintain confidentiality as stated in our Confidentiality Policy. Clients will also be held to the Confidentiality Agreement signed upon enrollment.

To participate in temporary Remote Client Services, sign the release below. A copy of the signed agreement will be emailed to Second Chance DUI. 

Remote Client Services Release

I, , agree to participate in temporary Remote Client Services (Telehealth) at Second Chance, Inc. I understand that specific technology is required to participate, and I certify that I have access to the required technology. Additionally, I have read and understood the Zoom privacy policy. I understand that Remote Client Services are being offered on a temporary basis due to the Coronavirus (COVID-19) pandemic and that once the threat is eliminated, client services will then be available at the DUI Program location only. To receive credit for the session, I understand that I must:

  • Attend the session in a private room, free of distractions.
  • Stay for the entire session.
  • Not be under the influence of alcohol or other drugs during the session.  

I understand that fees for DUI Program services will apply during this time and that Second Chance, Inc. will provide me with alternate payment options and methods during the Remote Client Services time period.

I have read and agree to the Second Chance, lnc. Remote Client Services Privacy Policy.

Consent to Receive Telephone Texts

Client Name:  

I give my permission for staff of Second Chance, Inc. to send me texts at this telephone number for the purpose of:

Select Types of Text Notifications

I understand that text messages are sent as a convenience. I understand and agree that I am responsible for attending scheduled services, making scheduled payments and following all other rules of the program whether I receive a text reminder or not.

I may revoke this consent at any time. Otherwise, it will expire one year from the date signed below.


Leave this empty:

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Signature Certificate
Document name: Remote Client Services and Text Notifications
lock iconUnique Document ID: 49e3e9d927b1e506f9618054411123a5b1c4e16c
January 11, 2021 12:22 pm MDTRemote Client Services and Text Notifications Uploaded by Heather Kim - IP
January 27, 2021 5:05 pm MDT Document owner has handed over this document to 2021-01-27 17:05:53 -
May 16, 2022 12:53 pm MDT Document owner has handed over this document to 2022-05-16 12:53:50 -