Authorization

Communication & Payment Consent

Give us permission to contact you about your coverage and process recurring payments for your plan.

Your Information

First Name

Last Name

Email Address

Mobile Phone

I authorize The Dental Vision Institute to:

Send me text messages (SMS)

Policy updates, payment reminders, claim notifications, renewal alerts, and support replies. Standard message and data rates may apply. Reply STOP to cancel at any time.

Call me by phone

Enrollment support, plan consultations, benefit questions, and verification calls from our licensed agents. Calls may be recorded for quality assurance.

Charge my card for recurring premiums

Automatic monthly billing of my plan premium on the scheduled date. I understand I can update or cancel auto-pay at any time through my member portal.

Send me marketing offers (optional)

Plan upgrade announcements, promotional discounts, and new product launches. You can unsubscribe any time.

I have read and agree to the Terms of Service, Privacy Policy, and the authorizations above. Consent is not a condition of purchase. This authorization remains in effect until I revoke it in writing or through the member portal.

Need to revoke consent later? Visit our Opt-Out page at any time.