Telecommunications Consent For Ai Use Form
Please complete this Telecommunications Consent For Ai Use Form to provide or update your consent regarding AI-enabled features in your telecommunications services.
Full Name
*
First Name
Last Name
Telecom Account Number or Reference
*
Primary Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Contact Email Address
*
example@example.com
Which service channels do you use with your telecom provider?
*
Mobile
Landline
Internet
TV
Other
Which AI-enabled uses do you consent to for your telecommunications services?
*
Personalized service recommendations
Automated customer support (chatbots, voice assistants)
Network optimization and quality monitoring
Fraud detection and security alerts
Other
Preferred communication channels for notifications about AI-enabled features
*
SMS
Email
Phone Call
In-app Notification
Please specify any limitations or restrictions on your consent for AI-enabled telecommunications use (if any)
Would you like the option to revoke your consent at any time?
*
Yes, I want to be able to revoke my consent at any time.
No, I do not require this option.
Date of Consent
*
-
Month
-
Day
Year
Date
Signature (Type your full name to confirm your consent)
*
Submit Consent
Should be Empty: