authorization to discontinue Receiving mass emails from change, inc. Instructions: If you would like to discontinue sending you mass emails as part of our commitment to excellent service and timely communication, please complete the authorization below. Today's Date(Required) MM slash DD slash YYYY Authorization(Required) I authorize Change, Inc. to discontinue sending me mass emails, including but not limited to any and all emails containing information blog posts, events, suggestions for improving my overall mental health/lifestyle, updates to important and therapy-impacting policies, changes to price structure, changes to the informed consent agreement, reminders, etc. I understand this means that its agreements with me, its prices, policies, etc. may change without my notice. I understand that Change, Inc. may still email me in the future in the event it is legally obligated to do so.Digital Signature(Required) Type Full NameAgreement(Required) By affixing by name below and giving my initials as a digital signature, I consent to the archival of my email from Change, Inc.'s mass email database.Email to be removed:(Required) Enter Email Confirm Email NOTE: Please verify this address by going back to the email you received from and ensuring to which email we sent it. If you have multiple email addresses on file, please complete this form as many times as needed.CAPTCHA Δ
