PublicProof Academy
A working document, not a submission form

AI consent and disclosure decision record

Document the questions a qualified reviewer must resolve before an AI calling or recording workflow is used.

Done when: The exact use, applicable permissions, disclosure, opt-out and unresolved legal questions are recorded.

Enable JavaScript for on-page entry and smart printing, or print a blank copy from your browser and complete it offline.

Inbound or outbound use

Describe who initiates contact, the business purpose and whether advertising or telemarketing is involved.

Audience and applicable locations

Identify recipient categories and jurisdictions for review, without entering recipient lists or private contact details.

Permission and evidence location

Describe the permission needed for this use and where approved evidence is retained. Do not paste consent records or infer permission from a purchased list.

Identity and AI disclosure

Record the proposed business identification and disclosure wording and the reviewer who must approve it.

Recording and opt-out handling

Identify the separate recording decision, suppression route and how stop requests prevent further unwanted contact.

Qualified review and release gate

List counsel or agency questions, decision date, reviewer and any conditions still blocking use. Do not treat proposals or this worksheet as enacted law.

Reference links and review boundary

Use the current issuer, payer, regulator, platform or qualified professional for your exact activity and location. These links informed the planning questions; they do not make this an official form, full compliance review or permission to operate.

Healthcare businesses are welcome for business education. PublicProof does not receive, store or process patient information. A completed worksheet does not establish HIPAA compliance, transport qualification, professional authority, account approval, a credential, reimbursement or revenue.

Worksheet updated October 20, 2026. Verify changing requirements before relying on them.