Unsolicited Contact Compliance Checklist
Complete this checklist to document and verify compliance with unsolicited contact regulations for all outreach activities.
Date of Contact
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Name of Contacted Individual or Organization
*
Contact Method
*
Phone Call
Email
Text Message (SMS)
Social Media Message
Other
Purpose of the Contact
*
Was prior consent obtained before making this contact?
*
Yes, consent was obtained and documented
No, consent was not obtained
If consent was obtained, specify how it was recorded
Was an opt-out option provided during the contact?
*
Yes, opt-out was clearly offered
No, opt-out was not provided
Source of Contact List
*
Please Select
Internal Database
Purchased List
Referral
Other
Staff Member Responsible for Contact
*
Internal Review Notes
Compliance Confirmation
*
All compliance steps have been followed
Some steps were missed (explain in notes)
Signature of Reviewer
*
Submit Compliance Checklist
Submit Compliance Checklist
Should be Empty: