SMS messaging & consent

Launch status: SMS is closed beta only. Twilio toll-free verification is approved for +1 855 806 4294, and must be used only for consented, minimum-necessary communication. Do not use SMS broadly for open-ended clinical conversation.

Miwa is a behavioral-health EHR and AI clinical assistant used by mental health clinicians in the United States. When SMS is enabled and a therapist sends an assessment, mood check-in, or appointment-related message to one of their clients, Miwa transmits that message via Twilio from a verified toll-free number on the therapist's behalf.

The therapist remains the originator of the communication. SMS content must stay limited to consented reminders, appointment prompts, and secure links.

Miwa does not collect SMS consent directly from clients through a web form. Consent is collected by the client's therapist as part of the existing therapeutic relationship, in one of two ways:

• In-session consent: the therapist explains in person (or during a telehealth session) that they would like to send the client assessment links, mood check-ins, and appointment reminders by text. The client agrees verbally or in writing.
• Intake-form consent: the therapist's intake paperwork (paper or electronic) includes explicit language asking the client to authorize SMS communication, including the types of messages they will receive and the right to opt out at any time.

Before saving a client's mobile number into Miwa, the therapist must affirmatively check a confirmation box stating that they obtained explicit consent for closed-beta SMS, offered a non-SMS alternative, explained STOP opt-out, and understand SMS should be limited to consented, minimum-necessary communications. Miwa records the timestamp of that confirmation alongside the phone number. SMS to that number is blocked until the confirmation is on file.

Mobile phone numbers and SMS consent records are never sold, rented, shared with third parties for marketing, or used for any purpose other than the therapist-to-client communication described here.

Clients only receive messages their therapist initiates. Miwa does not send marketing, promotional, or automated content to clients on its own. The categories of messages are:

• Assessment links, a short category message with a secure link.
• Check-ins, a short category prompt with a secure link.
• Portal messages or updates, a short category message with a secure portal link.
• Appointment-related messages, telehealth links and reminders the therapist chooses to send.

Sample messages:

• Frequency: messages are only sent when the client's therapist initiates one. Typical volume is fewer than 5 messages per month per client.
• Cost: Miwa does not charge clients for messages. Standard message-and-data rates from the client's mobile carrier may apply.
• Carriers: messages are delivered through Twilio across all major U.S. mobile carriers. Miwa is not liable for delays or failed messages caused by carriers.

Clients may opt out of SMS at any time using any of the following methods:

• Reply STOP, END, CANCEL, UNSUBSCRIBE, or QUIT to any message from Miwa. Twilio will automatically block further SMS to that number and send a one-time confirmation reply.
• Ask their therapist directly to remove their phone number or disable SMS, the therapist can do this from the client's profile in Miwa.
• Email support@miwa.care from any address and request removal.

To resume messages after opting out, reply START to any prior Miwa message, or ask the therapist to send a new consent confirmation.

Reply HELP to any Miwa SMS for an automated response with contact information, or email support@miwa.care for a human reply.

If a message reaches a number whose owner has not consented to Miwa SMS (for example, the wrong number was entered), please reply STOP and email privacy@miwa.care so we can investigate and remove the number from the sending therapist's account.

SMS messages from Miwa are intentionally minimal. They contain only the secure link a client needs to act on, the required STOP opt-out language, and the Miwa identifier. They never include client names, clinician names, assessment names, diagnoses, symptoms, scores, crisis details, session content, treatment details, clinical notes, or other clinical specifics.

See our full Privacy Policy for how Miwa handles sensitive clinical data.