diff --git a/prisma/migrations/0298_notification_delivery_identity/migration.sql b/prisma/migrations/0298_notification_delivery_identity/migration.sql
new file mode 100644
index 000000000..27691f2e4
--- /dev/null
+++ b/prisma/migrations/0298_notification_delivery_identity/migration.sql
@@ -0,0 +1,121 @@
+-- v1.37.0 — a notification names the health record it concerns and the
+-- account whose channels receive it. The former remains the source of health
+-- calculations and content; the latter owns delivery preferences and reach.
+--
+-- `user_id` remains as a legacy recipient mirror so established self-delivery
+-- writers and bounded historical readers stay valid while every row gains the
+-- explicit pair. The trigger maps an omitted pair to self-delivery, rejects a
+-- partial or inconsistent pair, and refuses a managed profile as recipient.
+
+ALTER TABLE "push_attempts"
+    ADD COLUMN "record_user_id" TEXT,
+    ADD COLUMN "recipient_user_id" TEXT;
+
+UPDATE "push_attempts"
+SET
+    "record_user_id" = "user_id",
+    "recipient_user_id" = "user_id";
+
+ALTER TABLE "push_attempts"
+    ALTER COLUMN "record_user_id" SET NOT NULL,
+    ALTER COLUMN "recipient_user_id" SET NOT NULL;
+
+ALTER TABLE "push_attempts"
+    ADD CONSTRAINT "push_attempts_record_user_id_fkey"
+    FOREIGN KEY ("record_user_id") REFERENCES "users"("id")
+    ON DELETE CASCADE ON UPDATE CASCADE,
+    ADD CONSTRAINT "push_attempts_recipient_user_id_fkey"
+    FOREIGN KEY ("recipient_user_id") REFERENCES "users"("id")
+    ON DELETE CASCADE ON UPDATE CASCADE;
+
+CREATE INDEX "push_attempts_recipient_user_id_created_at_desc_idx"
+    ON "push_attempts" ("recipient_user_id", "created_at" DESC);
+
+CREATE INDEX "push_attempts_record_user_id_created_at_desc_idx"
+    ON "push_attempts" ("record_user_id", "created_at" DESC);
+
+CREATE TABLE "notification_events" (
+    "id" TEXT NOT NULL,
+    "record_user_id" TEXT NOT NULL,
+    "event_type" TEXT NOT NULL,
+    "dedup_key" TEXT NOT NULL,
+    "created_at" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+
+    CONSTRAINT "notification_events_pkey" PRIMARY KEY ("id"),
+    CONSTRAINT "notification_events_record_user_id_fkey"
+        FOREIGN KEY ("record_user_id") REFERENCES "users"("id")
+        ON DELETE CASCADE ON UPDATE CASCADE
+);
+
+CREATE INDEX "notification_events_record_user_id_event_type_dedup_key_created_at_desc_idx"
+    ON "notification_events" ("record_user_id", "event_type", "dedup_key", "created_at" DESC);
+
+-- Tracking belongs to the account that received the Telegram message. The
+-- prior subject-only key collapsed multiple delegated recipients into one row.
+ALTER TABLE "telegram_reminder_messages"
+    ADD COLUMN "recipient_user_id" TEXT;
+
+UPDATE "telegram_reminder_messages" AS "message"
+SET "recipient_user_id" = "medication"."user_id"
+FROM "medications" AS "medication"
+WHERE "medication"."id" = "message"."medication_id";
+
+ALTER TABLE "telegram_reminder_messages"
+    ALTER COLUMN "recipient_user_id" SET NOT NULL,
+    ADD CONSTRAINT "telegram_reminder_messages_recipient_user_id_fkey"
+        FOREIGN KEY ("recipient_user_id") REFERENCES "users"("id")
+        ON DELETE CASCADE ON UPDATE CASCADE;
+
+DROP INDEX "telegram_reminder_messages_med_sched_date_phase_tod_key";
+
+CREATE UNIQUE INDEX "telegram_reminder_messages_recipient_slot_key"
+    ON "telegram_reminder_messages" (
+        "recipient_user_id",
+        "medication_id",
+        "schedule_id",
+        "date",
+        "phase",
+        "time_of_day"
+    );
+
+CREATE FUNCTION enforce_push_attempt_attribution()
+RETURNS TRIGGER
+LANGUAGE plpgsql
+AS $$
+BEGIN
+    IF NEW.record_user_id IS NULL AND NEW.recipient_user_id IS NULL THEN
+        NEW.record_user_id := NEW.user_id;
+        NEW.recipient_user_id := NEW.user_id;
+    ELSIF NEW.record_user_id IS NULL OR NEW.recipient_user_id IS NULL THEN
+        RAISE EXCEPTION 'push attempt attribution requires both principals';
+    ELSIF NEW.user_id <> NEW.recipient_user_id THEN
+        RAISE EXCEPTION 'push attempt recipient must match user_id';
+    END IF;
+
+    IF EXISTS (
+        SELECT 1
+        FROM "users"
+        WHERE "id" = NEW.recipient_user_id
+          AND "managed_profile_at" IS NOT NULL
+    ) THEN
+        RAISE EXCEPTION 'managed profile cannot receive notification delivery';
+    END IF;
+
+    IF NEW.record_user_id <> NEW.recipient_user_id
+       AND NOT EXISTS (
+           SELECT 1
+           FROM "users"
+           WHERE "id" = NEW.record_user_id
+             AND "managed_profile_at" IS NOT NULL
+       ) THEN
+        RAISE EXCEPTION 'cross-principal delivery requires a managed record';
+    END IF;
+
+    RETURN NEW;
+END;
+$$;
+
+CREATE TRIGGER push_attempt_attribution_guard
+BEFORE INSERT OR UPDATE ON "push_attempts"
+FOR EACH ROW
+EXECUTE FUNCTION enforce_push_attempt_attribution();
diff --git a/prisma/schema.prisma b/prisma/schema.prisma
index 457e3a151..153febee0 100644
--- a/prisma/schema.prisma
+++ b/prisma/schema.prisma
@@ -860,7 +860,10 @@ model User {
   // 20 attempts ordered by recency. Daily prune at 03:35 Europe/Berlin
   // retires rows older than 90 days (see `handlePushAttemptCleanup` in
   // `reminder-worker.ts`).
-  pushAttempts                   PushAttempt[]
+  pushAttemptsForRecord          PushAttempt[]                  @relation("PushAttemptRecordUser")
+  pushAttemptsReceived           PushAttempt[]                  @relation("PushAttemptRecipientUser")
+  notificationEvents             NotificationEvent[]
+  telegramReminderMessages       TelegramReminderMessage[]
   // v1.10.3 — per-(user, day) Strain personal-anchor cache (day-total
   // TRIMP + running EWMA reference) so the nightly Strain engine anchors
   // the 0–100 map to the user's own training load without re-integrating
@@ -3362,24 +3365,26 @@ model ReminderPhaseConfig {
 }
 
 model TelegramReminderMessage {
-  id           String        @id @default(cuid())
-  medicationId String        @map("medication_id")
-  scheduleId   String        @map("schedule_id")
-  chatId       String        @map("chat_id")
-  messageId    Int           @map("message_id")
-  phase        ReminderPhase
-  sentAt       DateTime      @default(now()) @map("sent_at")
-  date         String // YYYY-MM-DD for day grouping
+  id              String        @id @default(cuid())
+  recipientUserId String        @map("recipient_user_id")
+  medicationId    String        @map("medication_id")
+  scheduleId      String        @map("schedule_id")
+  chatId          String        @map("chat_id")
+  messageId       Int           @map("message_id")
+  phase           ReminderPhase
+  sentAt          DateTime      @default(now()) @map("sent_at")
+  date            String // YYYY-MM-DD for day grouping
   /// v1.7.0 — time-of-day this reminder belongs to (HH:mm, user-local).
   /// Empty string = the single legacy window (pre-v1.7 rows + single-time
   /// schedules). Part of the dedup key so a multi-time schedule dispatches
   /// once per time-of-day per phase per day instead of once per day.
-  timeOfDay    String        @default("") @map("time_of_day")
+  timeOfDay       String        @default("") @map("time_of_day")
 
-  medication Medication         @relation(fields: [medicationId], references: [id], onDelete: Cascade)
-  schedule   MedicationSchedule @relation(fields: [scheduleId], references: [id], onDelete: Cascade)
+  recipientUser User               @relation(fields: [recipientUserId], references: [id], onDelete: Cascade)
+  medication    Medication         @relation(fields: [medicationId], references: [id], onDelete: Cascade)
+  schedule      MedicationSchedule @relation(fields: [scheduleId], references: [id], onDelete: Cascade)
 
-  @@unique([medicationId, scheduleId, date, phase, timeOfDay], map: "telegram_reminder_messages_med_sched_date_phase_tod_key")
+  @@unique([recipientUserId, medicationId, scheduleId, date, phase, timeOfDay], map: "telegram_reminder_messages_recipient_slot_key")
   @@index([medicationId, date])
   @@map("telegram_reminder_messages")
 }
@@ -5803,6 +5808,22 @@ model ConsentReceipt {
 // `channel` is the dispatcher `ChannelType` string (`APNS`,
 // `WEB_PUSH`, `TELEGRAM`, `NTFY`).
 //
+// Record-scoped notification events are durable event anchors rather than
+// channel delivery records. They intentionally name no recipient, which keeps
+// scheduler deduplication independent from future Guardian fan-out.
+model NotificationEvent {
+  id           String   @id @default(cuid())
+  recordUserId String   @map("record_user_id")
+  eventType    String   @map("event_type")
+  dedupKey     String   @map("dedup_key")
+  createdAt    DateTime @default(now()) @map("created_at")
+
+  recordUser User @relation(fields: [recordUserId], references: [id], onDelete: Cascade)
+
+  @@index([recordUserId, eventType, dedupKey, createdAt(sort: Desc)])
+  @@map("notification_events")
+}
+
 // `result` is one of `"ok"` | `"error"` | `"skipped"` — `skipped`
 // covers the "no recipient" / "config missing" soft cases.
 //
@@ -5812,17 +5833,26 @@ model ConsentReceipt {
 // classified `web_push_*` reason; Telegram / NTFY likewise mirror
 // their sender-side `SendOutcome.reason`.
 model PushAttempt {
-  id        String   @id @default(cuid())
-  userId    String   @map("user_id")
-  channel   String // "APNS" | "WEB_PUSH" | "TELEGRAM" | "NTFY"
-  eventType String   @map("event_type") // dispatcher event-type string
-  result    String // "ok" | "error" | "skipped"
-  reason    String? // sender-side reason on error/skip; null on ok
-  createdAt DateTime @default(now()) @map("created_at")
+  id              String   @id @default(cuid())
+  /// Legacy recipient mirror. Migration 0298 preserves established writers
+  /// while the database trigger requires it to equal `recipientUserId`.
+  userId          String   @map("user_id")
+  /// The health-record subject. This supplies calculation context and content.
+  recordUserId    String?  @map("record_user_id")
+  /// The account whose channel, preferences, and locale receive the delivery.
+  recipientUserId String?  @map("recipient_user_id")
+  channel         String // "APNS" | "WEB_PUSH" | "TELEGRAM" | "NTFY"
+  eventType       String   @map("event_type") // dispatcher event-type string
+  result          String // "ok" | "error" | "skipped"
+  reason          String? // sender-side reason on error/skip; null on ok
+  createdAt       DateTime @default(now()) @map("created_at")
 
-  user User @relation(fields: [userId], references: [id], onDelete: Cascade)
+  recordUser    User? @relation("PushAttemptRecordUser", fields: [recordUserId], references: [id], onDelete: Cascade)
+  recipientUser User? @relation("PushAttemptRecipientUser", fields: [recipientUserId], references: [id], onDelete: Cascade)
 
   @@index([userId, createdAt(sort: Desc)])
+  @@index([recordUserId, createdAt(sort: Desc)])
+  @@index([recipientUserId, createdAt(sort: Desc)])
   @@map("push_attempts")
 }
 
diff --git a/src/__tests__/notification-delivery-identity.test.ts b/src/__tests__/notification-delivery-identity.test.ts
new file mode 100644
index 000000000..7cd591d7d
--- /dev/null
+++ b/src/__tests__/notification-delivery-identity.test.ts
@@ -0,0 +1,183 @@
+import { beforeEach, describe, expect, it, vi } from "vitest";
+
+const transactionMock = vi.fn();
+
+vi.mock("@/lib/db", () => ({
+  prisma: {
+    notificationChannel: {
+      findMany: vi.fn(),
+      update: vi.fn(),
+      upsert: vi.fn(),
+    },
+    user: { findUnique: vi.fn() },
+    auditLog: { create: vi.fn() },
+    $transaction: (...args: unknown[]) => transactionMock(...args),
+  },
+}));
+
+vi.mock("@/lib/auth/audit", () => ({
+  auditLog: vi.fn(async () => undefined),
+}));
+
+vi.mock("@/lib/crypto", () => ({
+  decrypt: (value: string) => value,
+  encrypt: (value: string) => value,
+}));
+
+vi.mock("@/lib/logging/context", () => ({
+  getEvent: () => ({
+    addWarning: vi.fn(),
+    addMeta: vi.fn(),
+  }),
+}));
+
+const sendViaWebPushMock = vi.fn();
+
+vi.mock("@/lib/notifications/senders/apns", () => ({
+  sendViaApns: vi.fn(),
+}));
+vi.mock("@/lib/notifications/senders/email", () => ({
+  sendViaEmail: vi.fn(),
+}));
+vi.mock("@/lib/notifications/senders/ntfy", () => ({
+  sendViaNtfy: vi.fn(),
+}));
+vi.mock("@/lib/notifications/senders/telegram", () => ({
+  sendViaTelegram: vi.fn(),
+}));
+vi.mock("@/lib/notifications/senders/web-push", () => ({
+  sendViaWebPush: (...args: unknown[]) => sendViaWebPushMock(...args),
+}));
+vi.mock("@/lib/notifications/senders/webhook", () => ({
+  sendViaWebhook: vi.fn(),
+}));
+vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
+  recordPushAttempt: vi.fn(),
+}));
+
+import { prisma } from "@/lib/db";
+import { dispatchNotification } from "@/lib/notifications/dispatcher";
+
+const recordUserId = "managed-record";
+const recipientUserId = "guardian-recipient";
+
+beforeEach(() => {
+  vi.resetAllMocks();
+  vi.mocked(prisma.user.findUnique).mockResolvedValue({
+    managedProfileAt: new Date(),
+  } as never);
+  vi.mocked(prisma.notificationChannel.findMany).mockResolvedValue([
+    {
+      id: "recipient-channel",
+      userId: recipientUserId,
+      type: "WEB_PUSH",
+      config: "{}",
+      nextRetryAt: null,
+      preferences: [],
+    },
+  ] as never);
+  vi.mocked(prisma.notificationChannel.update).mockResolvedValue({
+    consecutiveFailures: 0,
+  } as never);
+  transactionMock.mockImplementation(
+    async (operation: (tx: unknown) => Promise<unknown>) =>
+      operation({
+        $queryRaw: vi.fn(),
+        user: {
+          findUnique: vi.fn(async ({ where }: { where: { id: string } }) =>
+            where.id === recordUserId
+              ? { managedProfileAt: new Date() }
+              : { managedProfileAt: null },
+          ),
+        },
+        accountGrant: { findFirst: vi.fn(async () => ({ id: "grant" })) },
+      }),
+  );
+  sendViaWebPushMock.mockResolvedValue({ ok: true });
+});
+
+describe("notification delivery identity", () => {
+  it("principal resolution uses the recipient channel for a managed record", async () => {
+    const outcome = await dispatchNotification({
+      eventType: "MEDICATION_REMINDER",
+      userId: recordUserId,
+      recordUserId,
+      recipientUserId,
+      title: "Record content",
+      message: "Record schedule",
+    });
+
+    expect(outcome).toEqual({
+      dispatched: true,
+      channelsAttempted: 1,
+      channelsSucceeded: 1,
+    });
+    expect(prisma.notificationChannel.findMany).toHaveBeenCalledWith(
+      expect.objectContaining({
+        where: { userId: recipientUserId, enabled: true },
+      }),
+    );
+    expect(sendViaWebPushMock).toHaveBeenCalledWith(
+      recipientUserId,
+      expect.objectContaining({
+        userId: recordUserId,
+        recordUserId,
+        recipientUserId,
+        title: "Record content",
+        message: "Record schedule",
+      }),
+    );
+    expect(transactionMock).toHaveBeenCalledTimes(1);
+  });
+
+  it("refuses a managed record without an explicit recipient", async () => {
+    const outcome = await dispatchNotification({
+      eventType: "MEDICATION_REMINDER",
+      userId: recordUserId,
+      title: "Record content",
+      message: "Record schedule",
+    });
+
+    expect(outcome).toEqual({
+      dispatched: false,
+      channelsAttempted: 0,
+      channelsSucceeded: 0,
+    });
+    expect(prisma.notificationChannel.findMany).not.toHaveBeenCalled();
+    expect(sendViaWebPushMock).not.toHaveBeenCalled();
+  });
+
+  it("uses the recipient preference without changing record content", async () => {
+    vi.mocked(prisma.notificationChannel.findMany).mockResolvedValue([
+      {
+        id: "recipient-channel",
+        userId: recipientUserId,
+        type: "WEB_PUSH",
+        config: "{}",
+        nextRetryAt: null,
+        preferences: [{ eventType: "MEDICATION_REMINDER", enabled: false }],
+      },
+    ] as never);
+
+    const outcome = await dispatchNotification({
+      eventType: "MEDICATION_REMINDER",
+      userId: recordUserId,
+      recordUserId,
+      recipientUserId,
+      title: "Record content",
+      message: "Record schedule",
+    });
+
+    expect(outcome).toEqual({
+      dispatched: false,
+      channelsAttempted: 0,
+      channelsSucceeded: 0,
+    });
+    expect(prisma.notificationChannel.findMany).toHaveBeenCalledWith(
+      expect.objectContaining({
+        where: { userId: recipientUserId, enabled: true },
+      }),
+    );
+    expect(sendViaWebPushMock).not.toHaveBeenCalled();
+  });
+});
diff --git a/src/app/api/admin/notifications/diagnostic/__tests__/route.test.ts b/src/app/api/admin/notifications/diagnostic/__tests__/route.test.ts
index 8581ebece..bd873039c 100644
--- a/src/app/api/admin/notifications/diagnostic/__tests__/route.test.ts
+++ b/src/app/api/admin/notifications/diagnostic/__tests__/route.test.ts
@@ -68,7 +68,6 @@ vi.mock("@/lib/crypto", () => ({
 import { GET } from "../route";
 import { prisma } from "@/lib/db";
 import { requireAdmin, HttpError } from "@/lib/api-handler";
-import { REMINDER_DEDUP_CHANNEL } from "@/lib/notifications/reminder-dedup";
 
 const ADMIN_USER_ID = "admin-1";
 const ADMIN_CTX = {
@@ -97,6 +96,8 @@ interface DiagnosticEnvelope {
       configPresent: boolean;
     }>;
     recentPushAttempts: Array<{
+      recordUserId: string;
+      recipientUserId: string;
       eventType: string;
       channel: string;
       result: string;
@@ -341,6 +342,8 @@ describe("GET /api/admin/notifications/diagnostic — recentPushAttempts", () =>
     // mapping step normalises to an ISO string under `at`.
     vi.mocked(prisma.pushAttempt.findMany).mockResolvedValue([
       {
+        recordUserId: "managed-record",
+        recipientUserId: ADMIN_USER_ID,
         eventType: "MEDICATION_REMINDER",
         channel: "APNS",
         result: "ok",
@@ -348,6 +351,8 @@ describe("GET /api/admin/notifications/diagnostic — recentPushAttempts", () =>
         createdAt: new Date("2026-05-22T09:00:00.000Z"),
       },
       {
+        recordUserId: ADMIN_USER_ID,
+        recipientUserId: ADMIN_USER_ID,
         eventType: "MOOD_REMINDER",
         channel: "TELEGRAM",
         result: "error",
@@ -362,6 +367,8 @@ describe("GET /api/admin/notifications/diagnostic — recentPushAttempts", () =>
     expect(res.status).toBe(200);
     expect(body.data.recentPushAttempts).toEqual([
       {
+        recordUserId: "managed-record",
+        recipientUserId: ADMIN_USER_ID,
         eventType: "MEDICATION_REMINDER",
         channel: "APNS",
         result: "ok",
@@ -369,6 +376,8 @@ describe("GET /api/admin/notifications/diagnostic — recentPushAttempts", () =>
         at: "2026-05-22T09:00:00.000Z",
       },
       {
+        recordUserId: ADMIN_USER_ID,
+        recipientUserId: ADMIN_USER_ID,
         eventType: "MOOD_REMINDER",
         channel: "TELEGRAM",
         result: "error",
@@ -386,28 +395,24 @@ describe("GET /api/admin/notifications/diagnostic — recentPushAttempts", () =>
 
     expect(vi.mocked(prisma.pushAttempt.findMany)).toHaveBeenCalledTimes(1);
     const args = vi.mocked(prisma.pushAttempt.findMany).mock.calls[0]?.[0] as {
-      where: { userId: string };
+      where: { recipientUserId: string };
       orderBy: { createdAt: "desc" };
       take: number;
     };
-    expect(args.where.userId).toBe(ADMIN_USER_ID);
+    expect(args.where.recipientUserId).toBe(ADMIN_USER_ID);
     expect(args.orderBy).toEqual({ createdAt: "desc" });
     expect(args.take).toBe(20);
   });
 
-  it("excludes reminder-dedup bookkeeping rows so the last 20 are real sends", async () => {
-    // The medication tick anchors its per-slot dedup in this table under a
-    // sentinel channel. Letting those rows into the trailing window would
-    // push the actual delivery attempts — the thing an operator opens this
-    // endpoint for — off the list.
+  it("reads recipient-scoped delivery attempts without bookkeeping sentinels", async () => {
     vi.mocked(requireAdmin).mockResolvedValue(ADMIN_CTX);
     vi.mocked(prisma.pushAttempt.findMany).mockResolvedValue([] as never);
 
     await GET();
 
     const args = vi.mocked(prisma.pushAttempt.findMany).mock.calls[0]?.[0] as {
-      where: { channel?: { not?: string } };
+      where: { recipientUserId?: string };
     };
-    expect(args.where.channel).toEqual({ not: REMINDER_DEDUP_CHANNEL });
+    expect(args.where).toEqual({ recipientUserId: ADMIN_USER_ID });
   });
 });
diff --git a/src/app/api/admin/notifications/diagnostic/route.ts b/src/app/api/admin/notifications/diagnostic/route.ts
index 9c80e4df9..9b977842e 100644
--- a/src/app/api/admin/notifications/diagnostic/route.ts
+++ b/src/app/api/admin/notifications/diagnostic/route.ts
@@ -4,7 +4,6 @@ import { annotate } from "@/lib/logging/context";
 import { apiSuccess } from "@/lib/api-response";
 import { decrypt } from "@/lib/crypto";
 import type { ChannelType } from "@/lib/notifications/types";
-import { REMINDER_DEDUP_CHANNEL } from "@/lib/notifications/reminder-dedup";
 
 export const dynamic = "force-dynamic";
 
@@ -59,6 +58,8 @@ interface DiagnosticChannel {
 }
 
 interface DiagnosticPushAttempt {
+  recordUserId: string;
+  recipientUserId: string;
   eventType: string;
   channel: string;
   result: string;
@@ -170,18 +171,19 @@ export const GET = apiHandler(async () => {
       where: { userId: user.id },
       select: { type: true, enabled: true, config: true },
     }),
-    // v1.4.49 — trailing 20 push attempts for the calling admin's own
-    // account. The `(user_id, created_at DESC)` index on `push_attempts`
-    // turns the orderBy + take into a single index scan, so the cost is
-    // bounded regardless of the user's lifetime push volume.
+    // Trailing delivery attempts for the calling account as recipient. The
+    // recipient index keeps the bounded diagnostic read independent of the
+    // account's lifetime notification volume.
     prisma.pushAttempt.findMany({
-      // The reminder tick's per-slot dedup anchors live in this table under
-      // a sentinel channel. They are bookkeeping, not delivery attempts,
-      // and would push the real sends out of the trailing window.
-      where: { userId: user.id, channel: { not: REMINDER_DEDUP_CHANNEL } },
+      where: {
+        recipientUserId: user.id,
+      },
       orderBy: { createdAt: "desc" },
       take: 20,
       select: {
+        userId: true,
+        recordUserId: true,
+        recipientUserId: true,
         eventType: true,
         channel: true,
         result: true,
@@ -215,6 +217,8 @@ export const GET = apiHandler(async () => {
   // `DiagnosticPushAttempt` interface above (the existing consumer
   // contract uses `at`, not `createdAt`).
   const recentPushAttempts: DiagnosticPushAttempt[] = pushAttempts.map((a) => ({
+    recordUserId: a.recordUserId ?? a.userId,
+    recipientUserId: a.recipientUserId ?? a.userId,
     eventType: a.eventType,
     channel: a.channel,
     result: a.result,
diff --git a/src/app/api/admin/notifications/health/__tests__/route.test.ts b/src/app/api/admin/notifications/health/__tests__/route.test.ts
index a431abc2d..1cd02c79c 100644
--- a/src/app/api/admin/notifications/health/__tests__/route.test.ts
+++ b/src/app/api/admin/notifications/health/__tests__/route.test.ts
@@ -37,7 +37,6 @@ vi.mock("@/lib/logging/transports", () => ({ emitIfSampled: vi.fn() }));
 import { GET } from "../route";
 import { prisma } from "@/lib/db";
 import { requireAdmin, HttpError } from "@/lib/api-handler";
-import { REMINDER_DEDUP_CHANNEL } from "@/lib/notifications/reminder-dedup";
 import { NextRequest } from "next/server";
 
 const ADMIN_CTX = {
@@ -140,15 +139,12 @@ describe("GET /api/admin/notifications/health — aggregate", () => {
     ]);
   });
 
-  it("excludes reminder-dedup bookkeeping rows from the channel picture", async () => {
-    // The medication tick anchors its per-slot dedup in the same table
-    // under a sentinel channel. Those rows are not delivery attempts, so
-    // counting them would misreport what the channels are doing.
+  it("groups every delivery attempt in the selected window", async () => {
     await GET(req());
     const args = vi.mocked(prisma.pushAttempt.groupBy).mock.calls[0][0] as {
-      where: { channel?: { not?: string } };
+      where: { createdAt?: { gte?: Date } };
     };
-    expect(args.where.channel).toEqual({ not: REMINDER_DEDUP_CHANNEL });
+    expect(args.where.createdAt?.gte).toBeInstanceOf(Date);
   });
 
   it("defaults the window to 24h and clamps out-of-range values", async () => {
diff --git a/src/app/api/admin/notifications/health/route.ts b/src/app/api/admin/notifications/health/route.ts
index 47460a9f5..ab7228c39 100644
--- a/src/app/api/admin/notifications/health/route.ts
+++ b/src/app/api/admin/notifications/health/route.ts
@@ -2,7 +2,6 @@ import { prisma } from "@/lib/db";
 import { apiHandler, requireAdmin } from "@/lib/api-handler";
 import { annotate } from "@/lib/logging/context";
 import { apiSuccess } from "@/lib/api-response";
-import { REMINDER_DEDUP_CHANNEL } from "@/lib/notifications/reminder-dedup";
 
 export const dynamic = "force-dynamic";
 
@@ -59,12 +58,8 @@ export const GET = apiHandler(async (request) => {
   const [grouped, disabled] = await Promise.all([
     prisma.pushAttempt.groupBy({
       by: ["channel", "result"],
-      // The reminder tick anchors its per-slot dedup in the same table
-      // under a sentinel channel. Those rows record a decision, not a
-      // delivery, so they stay out of the per-channel health picture.
       where: {
         createdAt: { gte: since },
-        channel: { not: REMINDER_DEDUP_CHANNEL },
       },
       _count: { _all: true },
     }),
diff --git a/src/app/api/telegram/webhook/__tests__/route.test.ts b/src/app/api/telegram/webhook/__tests__/route.test.ts
index 634857667..05431bd59 100644
--- a/src/app/api/telegram/webhook/__tests__/route.test.ts
+++ b/src/app/api/telegram/webhook/__tests__/route.test.ts
@@ -291,6 +291,14 @@ describe("Telegram webhook — callback dispatch", () => {
     const res = await POST(tgRequest(callbackUpdate("taken:med-1")));
     expect(res.status).toBe(200);
 
+    expect(prisma.telegramReminderMessage.deleteMany).toHaveBeenCalledWith({
+      where: {
+        recipientUserId: "user-1",
+        medicationId: "med-1",
+        medication: { userId: "user-1" },
+      },
+    });
+
     // No schedules wired → the take is ad-hoc and inserts standalone.
     expect(prisma.medicationIntakeEvent.create).toHaveBeenCalledTimes(1);
     const intakeArgs = vi.mocked(prisma.medicationIntakeEvent.create).mock
@@ -779,6 +787,16 @@ describe("Telegram webhook — slot convergence (v1.16.9)", () => {
     const res = await POST(tgRequest(callbackUpdate("taken:med-1")));
     expect(res.status).toBe(200);
 
+    expect(prisma.telegramReminderMessage.findFirst).toHaveBeenCalledWith({
+      where: {
+        recipientUserId: "user-1",
+        medicationId: "med-1",
+        chatId: "7777",
+        messageId: 555,
+      },
+      select: { date: true, timeOfDay: true },
+    });
+
     // The pending row was updated in place — never a duplicate insert.
     expect(prisma.medicationIntakeEvent.create).not.toHaveBeenCalled();
     expect(prisma.medicationIntakeEvent.update).toHaveBeenCalledTimes(1);
diff --git a/src/lib/data-wipe/wipe-plan.ts b/src/lib/data-wipe/wipe-plan.ts
index b30dbb111..ae0ddc698 100644
--- a/src/lib/data-wipe/wipe-plan.ts
+++ b/src/lib/data-wipe/wipe-plan.ts
@@ -161,6 +161,7 @@ export const WIPE_MODELS = [
   "NotificationChannel",
   "PushSubscription",
   "PushAttempt",
+  "NotificationEvent",
   "Device",
   "TelegramScheduledDeletion",
   "TelegramPromptContext",
@@ -421,6 +422,7 @@ export const WIPE_OWNER_FIELDS: Readonly<Record<string, readonly string[]>> = {
   // attribution and must not let deleting a manager erase another record's
   // import history.
   MedicationIntakeImportJob: ["recordUserId"],
+  NotificationEvent: ["recordUserId"],
   // Both sides. Wiping only the grantor side would leave the account still
   // holding read access to other people's records after it asked for
   // everything of its own to be deleted.
diff --git a/src/lib/export/backup-plan.ts b/src/lib/export/backup-plan.ts
index be2bd5208..ef5dee16d 100644
--- a/src/lib/export/backup-plan.ts
+++ b/src/lib/export/backup-plan.ts
@@ -405,7 +405,9 @@ export const NOT_IN_BACKUP_MODELS: Readonly<Record<string, string>> = {
 
   // Ledgers whose meaning is local to the deployment.
   PushAttempt:
-    "A 90-day delivery ledger for this host's sends, and since v1.33.1 also the anchor rows the reminder dedup writes under a sentinel channel. Both describe what this instance did; restoring either onto another host would assert sends it never made, and the dedup anchors would suppress reminders that host still owes.",
+    "A 90-day delivery ledger for this host's sends. Restoring it onto another host would assert sends it never made.",
+  NotificationEvent:
+    "A local notification dedup anchor. Restoring it onto another host would suppress reminders and safety notices that host still owes.",
   AuditLog:
     "An append-only record of actions taken on this instance. Merging one instance's audit trail into another's would make the trail untrue.",
   CoachUsage:
diff --git a/src/lib/illness/__tests__/red-flag-notify.test.ts b/src/lib/illness/__tests__/red-flag-notify.test.ts
index 9a852ca9c..9cdaf2399 100644
--- a/src/lib/illness/__tests__/red-flag-notify.test.ts
+++ b/src/lib/illness/__tests__/red-flag-notify.test.ts
@@ -10,10 +10,15 @@ import { afterEach, beforeEach, describe, expect, it, vi } from "vitest";
 const findFirstMock = vi.fn();
 const createMock = vi.fn();
 const dispatchMock = vi.fn();
+const userFindUniqueMock = vi.fn();
+const claimMock = vi.fn();
 
 vi.mock("@/lib/db", () => ({
   prisma: {
-    pushAttempt: {
+    user: {
+      findUnique: (...a: unknown[]) => userFindUniqueMock(...a),
+    },
+    notificationEvent: {
       findFirst: (...a: unknown[]) => findFirstMock(...a),
       create: (...a: unknown[]) => createMock(...a),
     },
@@ -28,6 +33,10 @@ vi.mock("@/lib/notifications/dispatch-localised", () => ({
   dispatchLocalisedNotification: (...a: unknown[]) => dispatchMock(...a),
 }));
 
+vi.mock("@/lib/notifications/reminder-dedup", () => ({
+  claimNotificationEvent: (...a: unknown[]) => claimMock(...a),
+}));
+
 import { notifyIllnessRedFlag } from "../red-flag-notify";
 import type { IllnessRedFlag } from "../correlation";
 
@@ -45,9 +54,11 @@ const feverFlag: IllnessRedFlag = {
 };
 
 beforeEach(() => {
+  userFindUniqueMock.mockReset().mockResolvedValue({ managedProfileAt: null });
   findFirstMock.mockReset().mockResolvedValue(null);
   createMock.mockReset().mockResolvedValue({});
   dispatchMock.mockReset().mockResolvedValue(undefined);
+  claimMock.mockReset().mockResolvedValue(true);
 });
 
 afterEach(() => vi.clearAllMocks());
@@ -85,25 +96,46 @@ describe("notifyIllnessRedFlag", () => {
     );
   });
 
-  it("de-dupes when a recent ledger row exists for the episode", async () => {
-    findFirstMock.mockResolvedValueOnce({ id: "prior" });
+  it("does not dispatch when a concurrent claimant already owns the episode", async () => {
+    claimMock.mockResolvedValueOnce(false);
     await notifyIllnessRedFlag({
       userId: "u1",
       episodeId: "e1",
       redFlags: [feverFlag],
     });
     expect(dispatchMock).not.toHaveBeenCalled();
-    expect(createMock).not.toHaveBeenCalled();
+    expect(claimMock).toHaveBeenCalledTimes(1);
   });
 
-  it("stamps the ledger anchor before dispatching", async () => {
+  it("claims the record event anchor before dispatching", async () => {
     await notifyIllnessRedFlag({
       userId: "u1",
       episodeId: "e9",
       redFlags: [feverFlag],
     });
-    expect(createMock).toHaveBeenCalledTimes(1);
-    expect(createMock.mock.calls[0][0].data.reason).toContain("e9");
+    expect(claimMock).toHaveBeenCalledWith(
+      expect.anything(),
+      expect.objectContaining({
+        recordUserId: "u1",
+        eventType: "SYSTEM_ALERT",
+        dedupKey: expect.stringContaining("e9"),
+      }),
+    );
+  });
+
+  it("does not dispatch or write an anchor for a managed profile", async () => {
+    userFindUniqueMock.mockResolvedValueOnce({
+      managedProfileAt: new Date("2026-08-06T00:00:00.000Z"),
+    });
+
+    await notifyIllnessRedFlag({
+      userId: "managed-record",
+      episodeId: "e1",
+      redFlags: [feverFlag],
+    });
+
+    expect(claimMock).not.toHaveBeenCalled();
+    expect(dispatchMock).not.toHaveBeenCalled();
   });
 
   it("never throws when dispatch fails", async () => {
diff --git a/src/lib/illness/__tests__/safety-floor-notify.test.ts b/src/lib/illness/__tests__/safety-floor-notify.test.ts
index cd2a5a6b1..0eef5e6a3 100644
--- a/src/lib/illness/__tests__/safety-floor-notify.test.ts
+++ b/src/lib/illness/__tests__/safety-floor-notify.test.ts
@@ -11,10 +11,15 @@ import { afterEach, beforeEach, describe, expect, it, vi } from "vitest";
 const findFirstMock = vi.fn();
 const createMock = vi.fn();
 const dispatchMock = vi.fn();
+const userFindUniqueMock = vi.fn();
+const claimMock = vi.fn();
 
 vi.mock("@/lib/db", () => ({
   prisma: {
-    pushAttempt: {
+    user: {
+      findUnique: (...a: unknown[]) => userFindUniqueMock(...a),
+    },
+    notificationEvent: {
       findFirst: (...a: unknown[]) => findFirstMock(...a),
       create: (...a: unknown[]) => createMock(...a),
     },
@@ -29,6 +34,10 @@ vi.mock("@/lib/notifications/dispatch-localised", () => ({
   dispatchLocalisedNotification: (...a: unknown[]) => dispatchMock(...a),
 }));
 
+vi.mock("@/lib/notifications/reminder-dedup", () => ({
+  claimNotificationEvent: (...a: unknown[]) => claimMock(...a),
+}));
+
 import { notifySafetyFloor } from "../safety-floor-notify";
 import type { SafetyFloorDecision } from "../safety-floors";
 
@@ -50,9 +59,11 @@ const glucoseLowSymptomatic: SafetyFloorDecision = {
 };
 
 beforeEach(() => {
+  userFindUniqueMock.mockReset().mockResolvedValue({ managedProfileAt: null });
   findFirstMock.mockReset().mockResolvedValue(null);
   createMock.mockReset().mockResolvedValue({});
   dispatchMock.mockReset().mockResolvedValue(undefined);
+  claimMock.mockReset().mockResolvedValue(true);
 });
 
 afterEach(() => vi.clearAllMocks());
@@ -94,20 +105,34 @@ describe("notifySafetyFloor", () => {
     expect(opts.params).toEqual({ value: 2.7, unit: "mmol/L", threshold: 3 });
   });
 
-  it("de-dupes by reason when a recent ledger row exists", async () => {
-    findFirstMock.mockResolvedValueOnce({ id: "prior" });
+  it("does not dispatch when a concurrent claimant owns the safety event", async () => {
+    claimMock.mockResolvedValueOnce(false);
     await notifySafetyFloor({ userId: "u1", decision: bpHigh });
     expect(dispatchMock).not.toHaveBeenCalled();
-    expect(createMock).not.toHaveBeenCalled();
+    expect(claimMock).toHaveBeenCalledTimes(1);
   });
 
-  it("stamps the ledger anchor (keyed by reason) before dispatching", async () => {
+  it("claims the record event anchor (keyed by reason) before dispatching", async () => {
     await notifySafetyFloor({ userId: "u9", decision: bpHigh });
-    expect(createMock).toHaveBeenCalledTimes(1);
-    expect(createMock.mock.calls[0][0].data.reason).toContain(
-      "bp_hypertensive",
+    expect(claimMock).toHaveBeenCalledWith(
+      expect.anything(),
+      expect.objectContaining({
+        recordUserId: "u9",
+        eventType: "SYSTEM_ALERT",
+        dedupKey: expect.stringContaining("bp_hypertensive"),
+      }),
     );
-    expect(createMock.mock.calls[0][0].data.eventType).toBe("SYSTEM_ALERT");
+  });
+
+  it("does not dispatch or write an anchor for a managed profile", async () => {
+    userFindUniqueMock.mockResolvedValueOnce({
+      managedProfileAt: new Date("2026-08-06T00:00:00.000Z"),
+    });
+
+    await notifySafetyFloor({ userId: "managed-record", decision: bpHigh });
+
+    expect(claimMock).not.toHaveBeenCalled();
+    expect(dispatchMock).not.toHaveBeenCalled();
   });
 
   it("never throws when dispatch fails", async () => {
diff --git a/src/lib/illness/__tests__/safety-floor-sustained.test.ts b/src/lib/illness/__tests__/safety-floor-sustained.test.ts
index bc874e075..70f0f4915 100644
--- a/src/lib/illness/__tests__/safety-floor-sustained.test.ts
+++ b/src/lib/illness/__tests__/safety-floor-sustained.test.ts
@@ -6,14 +6,19 @@
  * opened the episode's correlation tab. These tests pin the on-write seam:
  * a sustained run escalates on INGEST through the SAME illness red-flag push,
  * with the SAME run length (RED_FLAG_RUN_DAYS) and absolute floors the detector
- * uses, and the 24h ledger dedupe stops a 4th reading re-firing the alarm.
+ * uses, and the 24h record-event dedupe stops a 4th reading re-firing the alarm.
  *
  * Calendar-day bucketing runs against TZ=UTC (the gate's contract).
  */
 import { afterEach, beforeEach, describe, expect, it, vi } from "vitest";
 
-/** In-memory pushAttempt ledger so the 24h dedupe behaves across calls. */
-const ledger: Array<{ userId: string; reason: string }> = [];
+/** In-memory event claims so the 24h dedupe behaves across calls. */
+const ledger: Array<{
+  recordUserId: string;
+  eventType: string;
+  dedupKey: string;
+  createdAt: Date;
+}> = [];
 const measurementFindMany = vi.fn();
 const dispatchMock = vi.fn();
 
@@ -22,17 +27,8 @@ vi.mock("@/lib/db", () => ({
     measurement: {
       findMany: (...a: unknown[]) => measurementFindMany(...a),
     },
-    pushAttempt: {
-      findFirst: ({ where }: { where: { userId: string; reason: string } }) => {
-        const hit = ledger.find(
-          (r) => r.userId === where.userId && r.reason === where.reason,
-        );
-        return Promise.resolve(hit ? { id: "prior" } : null);
-      },
-      create: ({ data }: { data: { userId: string; reason: string } }) => {
-        ledger.push({ userId: data.userId, reason: data.reason });
-        return Promise.resolve({});
-      },
+    user: {
+      findUnique: vi.fn().mockResolvedValue({ managedProfileAt: null }),
     },
   },
 }));
@@ -49,6 +45,29 @@ vi.mock("@/lib/notifications/dispatch-localised", () => ({
   dispatchLocalisedNotification: (...a: unknown[]) => dispatchMock(...a),
 }));
 
+vi.mock("@/lib/notifications/reminder-dedup", () => ({
+  claimNotificationEvent: (
+    _prisma: unknown,
+    input: {
+      recordUserId: string;
+      eventType: string;
+      dedupKey: string;
+      since: Date;
+    },
+  ) => {
+    const existing = ledger.find(
+      (event) =>
+        event.recordUserId === input.recordUserId &&
+        event.eventType === input.eventType &&
+        event.dedupKey === input.dedupKey &&
+        event.createdAt >= input.since,
+    );
+    if (existing) return Promise.resolve(false);
+    ledger.push({ ...input, createdAt: new Date() });
+    return Promise.resolve(true);
+  },
+}));
+
 import { runSafetyFloorCheck } from "../safety-floor-check";
 
 /** A measured-at on a given UTC calendar day, mid-morning. */
diff --git a/src/lib/illness/red-flag-notify.ts b/src/lib/illness/red-flag-notify.ts
index d5cbf8916..2ac3c23a6 100644
--- a/src/lib/illness/red-flag-notify.ts
+++ b/src/lib/illness/red-flag-notify.ts
@@ -15,19 +15,20 @@
  * the strongest tier those channels support.
  *
  * Owner-scoped (the authenticated episode owner) and module-gated by the
- * caller (`requireIllnessEnabled`). De-duplicated through the `pushAttempt`
- * ledger: at most one escalation per episode per rolling window, so a
+ * caller (`requireIllnessEnabled`). De-duplicated through a record event:
+ * at most one escalation per episode per rolling window, so a
  * correlation surface that is re-read repeatedly never re-fires the alarm.
  */
 import { prisma } from "@/lib/db";
 import { getEvent } from "@/lib/logging/context";
 import { dispatchLocalisedNotification } from "@/lib/notifications/dispatch-localised";
+import { claimNotificationEvent } from "@/lib/notifications/reminder-dedup";
 import type { IllnessRedFlag } from "@/lib/illness/correlation";
 
 /** One escalation per episode per this window. */
 const DEDUPE_WINDOW_MS = 24 * 60 * 60 * 1000;
 
-/** Stable ledger reason prefix so the dedupe lookup is exact-matchable. */
+/** Stable event key prefix so the dedupe lookup is exact-matchable. */
 const LEDGER_REASON_PREFIX = "illness_red_flag:";
 
 /**
@@ -44,16 +45,26 @@ export async function notifyIllnessRedFlag(input: {
   if (redFlags.length === 0) return;
 
   try {
-    // Dedupe: skip when an escalation for THIS episode already landed in the
-    // ledger within the window. The episode id rides the `reason` column so
-    // the lookup is exact without a schema change.
+    // Plan 11 adds approved guardian fanout for this safety signal. Until
+    // then, managed profiles must not produce a direct delivery or anchor.
+    const user = await prisma.user.findUnique({
+      where: { id: userId },
+      select: { managedProfileAt: true },
+    });
+    if (user?.managedProfileAt) return;
+
+    // Claim this episode's record event before provider egress. The claim
+    // serializes concurrent readers without holding a transaction open for
+    // delivery itself.
     const reason = `${LEDGER_REASON_PREFIX}${episodeId}`;
     const since = new Date(Date.now() - DEDUPE_WINDOW_MS);
-    const prior = await prisma.pushAttempt.findFirst({
-      where: { userId, reason, createdAt: { gte: since } },
-      select: { id: true },
+    const claimed = await claimNotificationEvent(prisma, {
+      recordUserId: userId,
+      eventType: "SYSTEM_ALERT",
+      dedupKey: reason,
+      since,
     });
-    if (prior) return;
+    if (!claimed) return;
 
     // Prefer the most clinically actionable reason for the body. Both copy
     // keys already exist in every locale bundle (i18n integrity guarantee).
@@ -62,19 +73,6 @@ export async function notifyIllnessRedFlag(input: {
       ? "illness.correlation.redFlagFever"
       : "illness.correlation.redFlagSpo2";
 
-    // Stamp the ledger BEFORE dispatching so a slow/duplicate concurrent read
-    // can't double-fire. The senders write their own per-channel rows too;
-    // this synthetic row is purely the dedupe anchor.
-    await prisma.pushAttempt.create({
-      data: {
-        userId,
-        channel: "WEB_PUSH",
-        eventType: "SYSTEM_ALERT",
-        result: "skipped",
-        reason,
-      },
-    });
-
     await dispatchLocalisedNotification({
       userId,
       titleKey: "illness.correlation.redFlagTitle",
diff --git a/src/lib/illness/safety-floor-notify.ts b/src/lib/illness/safety-floor-notify.ts
index 23df53951..9065b8fa9 100644
--- a/src/lib/illness/safety-floor-notify.ts
+++ b/src/lib/illness/safety-floor-notify.ts
@@ -13,13 +13,14 @@
  *   - The body always echoes the (already re-confirmed) reading value.
  *
  * Dedup: at most one push per (user, reason) per rolling 24h window, anchored
- * on a synthetic `pushAttempt` row keyed by reason — so a user re-checking a
+ * on a record event keyed by reason — so a user re-checking a
  * stubbornly-high reading repeatedly doesn't get spammed. Owner-scoped, never
  * throws (a notification failure must not break the measurement write).
  */
 import { prisma } from "@/lib/db";
 import { getEvent } from "@/lib/logging/context";
 import { dispatchLocalisedNotification } from "@/lib/notifications/dispatch-localised";
+import { claimNotificationEvent } from "@/lib/notifications/reminder-dedup";
 import { convertGlucose, type GlucoseUnit } from "@/lib/glucose";
 import {
   GLUCOSE_HYPO,
@@ -31,7 +32,7 @@ import {
 /** One escalation per (user, reason) per this window. */
 const DEDUPE_WINDOW_MS = 24 * 60 * 60 * 1000;
 
-/** Stable ledger reason prefix so the dedupe lookup is exact-matchable. */
+/** Stable event key prefix so the dedupe lookup is exact-matchable. */
 const LEDGER_REASON_PREFIX = "safety_floor:";
 
 /**
@@ -113,26 +114,23 @@ export async function notifySafetyFloor(input: {
   if (!decision) return;
 
   try {
+    // Plan 11 adds approved guardian fanout for this safety signal. Until
+    // then, managed profiles must not produce a direct delivery or anchor.
+    const user = await prisma.user.findUnique({
+      where: { id: userId },
+      select: { managedProfileAt: true },
+    });
+    if (user?.managedProfileAt) return;
+
     const reason = `${LEDGER_REASON_PREFIX}${decision.reason}`;
     const since = new Date(Date.now() - DEDUPE_WINDOW_MS);
-    const prior = await prisma.pushAttempt.findFirst({
-      where: { userId, reason, createdAt: { gte: since } },
-      select: { id: true },
-    });
-    if (prior) return;
-
-    // Stamp the ledger BEFORE dispatching so a concurrent confirm can't
-    // double-fire. The senders write their own per-channel rows; this
-    // synthetic row is purely the dedupe anchor.
-    await prisma.pushAttempt.create({
-      data: {
-        userId,
-        channel: "WEB_PUSH",
-        eventType: "SYSTEM_ALERT",
-        result: "skipped",
-        reason,
-      },
+    const claimed = await claimNotificationEvent(prisma, {
+      recordUserId: userId,
+      eventType: "SYSTEM_ALERT",
+      dedupKey: reason,
+      since,
     });
+    if (!claimed) return;
 
     const { titleKey, messageKey } = copyKeysFor(decision);
     await dispatchLocalisedNotification({
diff --git a/src/lib/jobs/__tests__/medication-reminder-check.test.ts b/src/lib/jobs/__tests__/medication-reminder-check.test.ts
index 2db333d96..55ab1bfcd 100644
--- a/src/lib/jobs/__tests__/medication-reminder-check.test.ts
+++ b/src/lib/jobs/__tests__/medication-reminder-check.test.ts
@@ -103,9 +103,9 @@ vi.mock("@/lib/rollups/medication-compliance-rollups", () => ({
   recomputeMedicationComplianceForEvent: vi.fn().mockResolvedValue(undefined),
 }));
 vi.mock("@/lib/notifications/reminder-dedup", () => ({
-  hasReminderDedupAnchor: vi.fn().mockResolvedValue(false),
+  claimNotificationEvent: vi.fn().mockResolvedValue(true),
   medicationReminderDedupKey: vi.fn(() => "dedup-key"),
-  writeReminderDedupAnchor: vi.fn().mockResolvedValue(undefined),
+  REMINDER_DEDUP_LOOKBACK_MS: 48 * 60 * 60 * 1000,
 }));
 
 import { handleReminderCheck } from "@/lib/jobs/reminder/medication-reminder-check";
diff --git a/src/lib/jobs/__tests__/medication-reminder-dedup.test.ts b/src/lib/jobs/__tests__/medication-reminder-dedup.test.ts
index e11b6912f..dfa47aadd 100644
--- a/src/lib/jobs/__tests__/medication-reminder-dedup.test.ts
+++ b/src/lib/jobs/__tests__/medication-reminder-dedup.test.ts
@@ -9,7 +9,7 @@
  *     only when a Telegram send succeeds. A user on email / APNs / ntfy
  *     therefore never had a ledger row, so the 15-minute tick re-fired the
  *     same overdue notice for the rest of the day — roughly fifty mails per
- *     missed dose. The anchor now lives in `push_attempts` and is written
+ *     missed dose. The anchor now lives in `notification_events` and is written
  *     for every dispatched slot regardless of channel outcome.
  *
  *  2. **Coarser must not mean quieter.** The dedup is per phase and per
@@ -24,18 +24,18 @@
  */
 import { describe, expect, it, vi, beforeEach, afterEach } from "vitest";
 
-interface FakePushAttempt {
-  userId: string;
-  channel: string;
+interface FakeNotificationEvent {
+  recordUserId: string;
   eventType: string;
-  result: string;
-  reason: string | null;
+  dedupKey: string;
   createdAt: Date;
 }
 
-const pushAttempts: FakePushAttempt[] = [];
+const notificationEvents: FakeNotificationEvent[] = [];
 
 const prismaMock = {
+  $queryRaw: vi.fn().mockResolvedValue([{ locked: 1 }]),
+  $transaction: vi.fn(),
   telegramScheduledDeletion: {
     findMany: vi.fn().mockResolvedValue([]),
     deleteMany: vi.fn().mockResolvedValue({ count: 0 }),
@@ -56,11 +56,11 @@ const prismaMock = {
   telegramReminderMessage: {
     findUnique: vi.fn().mockResolvedValue(null),
   },
-  pushAttempt: {
+  notificationEvent: {
     create: vi.fn(
-      async ({ data }: { data: Omit<FakePushAttempt, "createdAt"> }) => {
-        pushAttempts.push({ ...data, createdAt: new Date() });
-        return { id: `pa-${pushAttempts.length}` };
+      async ({ data }: { data: Omit<FakeNotificationEvent, "createdAt"> }) => {
+        notificationEvents.push({ ...data, createdAt: new Date() });
+        return { id: `ne-${notificationEvents.length}` };
       },
     ),
     findFirst: vi.fn(
@@ -68,17 +68,17 @@ const prismaMock = {
         where,
       }: {
         where: {
-          userId: string;
+          recordUserId: string;
           eventType: string;
-          reason: string;
+          dedupKey: string;
           createdAt?: { gte: Date };
         };
       }) =>
-        pushAttempts.find(
+        notificationEvents.find(
           (row) =>
-            row.userId === where.userId &&
+            row.recordUserId === where.recordUserId &&
             row.eventType === where.eventType &&
-            row.reason === where.reason &&
+            row.dedupKey === where.dedupKey &&
             (where.createdAt?.gte === undefined ||
               row.createdAt >= where.createdAt.gte),
         ) ?? null,
@@ -189,7 +189,8 @@ async function tickAt(iso: string): Promise<void> {
 
 beforeEach(() => {
   vi.clearAllMocks();
-  pushAttempts.length = 0;
+  notificationEvents.length = 0;
+  prismaMock.$transaction.mockImplementation(async (run) => run(prismaMock));
   vi.useFakeTimers();
   prismaMock.telegramScheduledDeletion.findMany.mockResolvedValue([]);
   prismaMock.telegramPromptContext.deleteMany.mockResolvedValue({ count: 0 });
@@ -331,8 +332,8 @@ describe("issue #664 — dedup follows the scheduled occurrence across midnight"
     await tickAt("2026-07-28T22:30:00.000Z");
 
     expect(dispatchNotification).toHaveBeenCalledTimes(1);
-    expect(pushAttempts).toHaveLength(1);
-    expect(pushAttempts[0]?.reason).toBe(
+    expect(notificationEvents).toHaveLength(1);
+    expect(notificationEvents[0]?.dedupKey).toBe(
       "med:med-1:sched-1:23:45:YELLOW:2026-07-28",
     );
   });
diff --git a/src/lib/jobs/reminder/medication-reminder-check.ts b/src/lib/jobs/reminder/medication-reminder-check.ts
index 7cd887cac..1643f69ce 100644
--- a/src/lib/jobs/reminder/medication-reminder-check.ts
+++ b/src/lib/jobs/reminder/medication-reminder-check.ts
@@ -31,9 +31,9 @@ import {
   getPhaseKeyboard,
 } from "@/lib/jobs/reminder-phases";
 import {
-  hasReminderDedupAnchor,
+  claimNotificationEvent,
   medicationReminderDedupKey,
-  writeReminderDedupAnchor,
+  REMINDER_DEDUP_LOOKBACK_MS,
 } from "@/lib/notifications/reminder-dedup";
 import { getUserTodayBounds as getUserTodayBoundsUtil } from "@/lib/tz/local-day";
 import { getWorkerPrisma, parseTimeToMinutes } from "./shared";
@@ -544,13 +544,9 @@ export async function handleReminderCheck(
               continue;
             }
 
-            // Already notified for this slot, phase and local day? The
-            // anchor lives in `push_attempts` and is stamped for every
-            // dispatched slot regardless of which channels delivered. It
-            // used to be the Telegram message ledger, which is written only
-            // when a Telegram send succeeds — so a user on email / APNs /
-            // ntfy had no row and the tick re-sent the same overdue notice
-            // every 15 minutes for the rest of the day.
+            // Claim this slot/phase/local-day record event before mutable RED
+            // handling or provider egress. The short locked transaction keeps
+            // concurrent reminder ticks from both minting and delivering it.
             const dedupReason = medicationReminderDedupKey({
               medicationId: med.id,
               scheduleId: schedule.id,
@@ -561,15 +557,14 @@ export async function handleReminderCheck(
               }),
             });
 
-            if (
-              await hasReminderDedupAnchor(prisma, {
-                userId: med.user.id,
+            if (med.notificationsEnabled) {
+              const claimed = await claimNotificationEvent(prisma, {
+                recordUserId: med.user.id,
                 eventType: "MEDICATION_REMINDER",
-                reason: dedupReason,
-                now,
-              })
-            ) {
-              continue;
+                dedupKey: dedupReason,
+                since: new Date(now.getTime() - REMINDER_DEDUP_LOOKBACK_MS),
+              });
+              if (!claimed) continue;
             }
 
             const doseInfo = schedule.dose ?? med.dose;
@@ -651,15 +646,6 @@ export async function handleReminderCheck(
                 `${currentPhase}:${med.name}:${slotTime}`,
               );
 
-              // Stamp the dedup anchor BEFORE dispatching: a crash between
-              // the two costs this phase's notice, a repeat costs the user
-              // a notification every 15 minutes until the day rolls.
-              await writeReminderDedupAnchor(prisma, {
-                userId: med.user.id,
-                eventType: "MEDICATION_REMINDER",
-                reason: dedupReason,
-              });
-
               try {
                 await dispatchNotification({
                   eventType: "MEDICATION_REMINDER",
diff --git a/src/lib/notifications/__tests__/client-managed-apns.test.ts b/src/lib/notifications/__tests__/client-managed-apns.test.ts
index 9121c89a5..75a7a7b8c 100644
--- a/src/lib/notifications/__tests__/client-managed-apns.test.ts
+++ b/src/lib/notifications/__tests__/client-managed-apns.test.ts
@@ -137,7 +137,8 @@ describe("dispatchNotification — client-managed APNs suppression", () => {
       },
     );
     expect(recordPushAttemptMock).toHaveBeenCalledWith({
-      userId: "u-1",
+      recordUserId: "u-1",
+      recipientUserId: "u-1",
       channel: "APNS",
       eventType: "MEDICATION_REMINDER",
       result: "skipped",
diff --git a/src/lib/notifications/__tests__/dispatcher.test.ts b/src/lib/notifications/__tests__/dispatcher.test.ts
index b8b543938..3e2deb809 100644
--- a/src/lib/notifications/__tests__/dispatcher.test.ts
+++ b/src/lib/notifications/__tests__/dispatcher.test.ts
@@ -86,7 +86,9 @@ function makeChannel(over: Partial<MockChannel> = {}): MockChannel {
 
 beforeEach(() => {
   vi.resetAllMocks();
-  vi.mocked(prisma.user.findUnique).mockResolvedValue(null as never);
+  vi.mocked(prisma.user.findUnique).mockResolvedValue({
+    managedProfileAt: null,
+  } as never);
   // Default: every update returns a counter of 1 — individual tests
   // override the resolved value when they need to drive a specific
   // failure count (e.g. the "5th in a row" give-up test).
diff --git a/src/lib/notifications/__tests__/reminder-dedup.test.ts b/src/lib/notifications/__tests__/reminder-dedup.test.ts
new file mode 100644
index 000000000..8c84a4305
--- /dev/null
+++ b/src/lib/notifications/__tests__/reminder-dedup.test.ts
@@ -0,0 +1,76 @@
+import { beforeEach, describe, expect, it, vi } from "vitest";
+
+import { prisma } from "@/lib/db";
+
+const findFirstMock = vi.fn();
+const createMock = vi.fn();
+const queryRawMock = vi.fn();
+const transactionMock = vi.fn();
+
+vi.mock("@/lib/db", () => ({
+  prisma: {
+    $queryRaw: (...args: unknown[]) => queryRawMock(...args),
+    $transaction: (...args: unknown[]) => transactionMock(...args),
+    notificationEvent: {
+      findFirst: (...args: unknown[]) => findFirstMock(...args),
+      create: (...args: unknown[]) => createMock(...args),
+    },
+  },
+}));
+
+import { claimNotificationEvent } from "../reminder-dedup";
+
+beforeEach(() => {
+  findFirstMock.mockReset().mockResolvedValue(null);
+  createMock.mockReset().mockResolvedValue({ id: "event" });
+  queryRawMock.mockReset().mockResolvedValue([{ locked: 1 }]);
+  transactionMock.mockReset().mockImplementation(async (run) => run(prisma));
+});
+
+describe("reminder dedup anchors", () => {
+  it("claims one record-scoped event under a short transaction lock", async () => {
+    const now = new Date("2026-08-06T08:00:00.000Z");
+
+    await expect(
+      claimNotificationEvent(prisma as never, {
+        recordUserId: "managed-record",
+        eventType: "MEDICATION_REMINDER",
+        dedupKey: "med:slot",
+        since: now,
+      }),
+    ).resolves.toBe(true);
+
+    expect(queryRawMock).toHaveBeenCalledTimes(1);
+    expect(findFirstMock).toHaveBeenCalledWith(
+      expect.objectContaining({
+        where: expect.objectContaining({
+          recordUserId: "managed-record",
+          eventType: "MEDICATION_REMINDER",
+          dedupKey: "med:slot",
+        }),
+      }),
+    );
+    expect(createMock).toHaveBeenCalledWith({
+      data: {
+        recordUserId: "managed-record",
+        eventType: "MEDICATION_REMINDER",
+        dedupKey: "med:slot",
+      },
+    });
+  });
+
+  it("does not claim when the locked window already contains the event", async () => {
+    findFirstMock.mockResolvedValueOnce({ id: "prior" });
+
+    await expect(
+      claimNotificationEvent(prisma as never, {
+        recordUserId: "managed-record",
+        eventType: "MEDICATION_REMINDER",
+        dedupKey: "med:slot",
+        since: new Date("2026-08-06T08:00:00.000Z"),
+      }),
+    ).resolves.toBe(false);
+
+    expect(createMock).not.toHaveBeenCalled();
+  });
+});
diff --git a/src/lib/notifications/__tests__/web-push-dose-clear.test.ts b/src/lib/notifications/__tests__/web-push-dose-clear.test.ts
index 5fd17e260..684a85cea 100644
--- a/src/lib/notifications/__tests__/web-push-dose-clear.test.ts
+++ b/src/lib/notifications/__tests__/web-push-dose-clear.test.ts
@@ -45,6 +45,7 @@ vi.mock("@/lib/logging/context", () => ({
 
 vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
   recordPushAttempt: vi.fn(),
+  recordPushAttemptForPayload: vi.fn(),
 }));
 
 vi.mock("@/lib/db", () => ({
diff --git a/src/lib/notifications/__tests__/web-push-egress-pin.test.ts b/src/lib/notifications/__tests__/web-push-egress-pin.test.ts
index 00885c993..488d4574b 100644
--- a/src/lib/notifications/__tests__/web-push-egress-pin.test.ts
+++ b/src/lib/notifications/__tests__/web-push-egress-pin.test.ts
@@ -38,6 +38,7 @@ vi.mock("@/lib/logging/context", () => ({
 
 vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
   recordPushAttempt: vi.fn(),
+  recordPushAttemptForPayload: vi.fn(),
 }));
 
 vi.mock("@/lib/db", () => ({
diff --git a/src/lib/notifications/delivery-identity.ts b/src/lib/notifications/delivery-identity.ts
new file mode 100644
index 000000000..3283dddb1
--- /dev/null
+++ b/src/lib/notifications/delivery-identity.ts
@@ -0,0 +1,76 @@
+import { prisma } from "@/lib/db";
+import {
+  activeGuardianWhere,
+  withManagedProfileLock,
+} from "@/lib/managed-profiles/lifecycle";
+import type { NotificationPayload } from "@/lib/notifications/types";
+
+export interface NotificationDeliveryIdentity {
+  recordUserId: string;
+  recipientUserId: string;
+  managed: boolean;
+}
+
+/**
+ * Resolve notification identities without treating a managed record as its
+ * own destination. Legacy payloads remain valid only for ordinary self
+ * delivery; a managed record must name an active Guardian explicitly.
+ *
+ * Cross-principal authorization linearizes at the locked grant read below,
+ * immediately before the dispatcher selects a channel. A revocation that
+ * commits before that read prevents delivery; one that commits afterwards
+ * affects later dispatches but cannot recall provider work already in flight.
+ * The provider call deliberately runs outside the short database transaction.
+ */
+export async function resolveNotificationDeliveryIdentity(
+  payload: NotificationPayload,
+): Promise<NotificationDeliveryIdentity | null> {
+  const hasRecordUserId = payload.recordUserId !== undefined;
+  const hasRecipientUserId = payload.recipientUserId !== undefined;
+
+  if (hasRecordUserId !== hasRecipientUserId) return null;
+
+  const recordUserId = payload.recordUserId ?? payload.userId;
+  const recipientUserId = payload.recipientUserId ?? payload.userId;
+  if (!recordUserId || !recipientUserId || payload.userId !== recordUserId) {
+    return null;
+  }
+
+  const record = await prisma.user.findUnique({
+    where: { id: recordUserId },
+    select: { managedProfileAt: true },
+  });
+  if (!record) return null;
+
+  if (record.managedProfileAt == null) {
+    return recipientUserId === recordUserId
+      ? { recordUserId, recipientUserId, managed: false }
+      : null;
+  }
+
+  if (recipientUserId === recordUserId) return null;
+
+  return prisma.$transaction(async (tx) =>
+    withManagedProfileLock(tx, recordUserId, async (lockedRecord) => {
+      if (lockedRecord?.managedProfileAt == null) return null;
+
+      const recipient = await tx.user.findUnique({
+        where: { id: recipientUserId },
+        select: { managedProfileAt: true },
+      });
+      if (!recipient || recipient.managedProfileAt != null) return null;
+
+      const guardian = await tx.accountGrant.findFirst({
+        where: {
+          grantorId: recordUserId,
+          granteeId: recipientUserId,
+          ...activeGuardianWhere(new Date()),
+        },
+        select: { id: true },
+      });
+      if (!guardian) return null;
+
+      return { recordUserId, recipientUserId, managed: true };
+    }),
+  );
+}
diff --git a/src/lib/notifications/dispatch-localised.ts b/src/lib/notifications/dispatch-localised.ts
index 6278febbb..2311286b3 100644
--- a/src/lib/notifications/dispatch-localised.ts
+++ b/src/lib/notifications/dispatch-localised.ts
@@ -45,6 +45,8 @@ import type { EventType } from "@/lib/notifications/types";
 
 interface DispatchLocalisedOptions {
   userId: string;
+  recordUserId?: string;
+  recipientUserId?: string;
   titleKey: string;
   messageKey: string;
   params?: Record<string, string | number>;
@@ -147,7 +149,9 @@ async function resolveRecipientLocale(userId: string): Promise<Locale> {
 export async function dispatchLocalisedNotification(
   opts: DispatchLocalisedOptions,
 ): Promise<void> {
-  const locale = await resolveRecipientLocale(opts.userId);
+  const locale = await resolveRecipientLocale(
+    opts.recipientUserId ?? opts.userId,
+  );
   const t = getServerTranslator(locale).t;
 
   const title = t(opts.titleKey, opts.params);
@@ -173,6 +177,8 @@ export async function dispatchLocalisedNotification(
   await dispatchNotification({
     eventType: opts.eventType ?? "SYSTEM_ALERT",
     userId: opts.userId,
+    recordUserId: opts.recordUserId,
+    recipientUserId: opts.recipientUserId,
     title,
     message,
     metadata,
diff --git a/src/lib/notifications/dispatcher.ts b/src/lib/notifications/dispatcher.ts
index 48336ef85..77fed2b7d 100644
--- a/src/lib/notifications/dispatcher.ts
+++ b/src/lib/notifications/dispatcher.ts
@@ -29,6 +29,7 @@ import {
   hasClientManagedApnsGate,
 } from "@/lib/notifications/client-managed-apns";
 import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { resolveNotificationDeliveryIdentity } from "@/lib/notifications/delivery-identity";
 
 /**
  * Dispatch a notification to all enabled channels for a user.
@@ -63,11 +64,21 @@ export async function dispatchNotification(
   let channelsSucceeded = 0;
 
   try {
+    const delivery = await resolveNotificationDeliveryIdentity(payload);
+    if (!delivery) {
+      getEvent()?.addWarning("Notification delivery identity was invalid");
+      return { dispatched: false, channelsAttempted, channelsSucceeded };
+    }
+    const deliveryPayload: NotificationPayload = {
+      ...payload,
+      recordUserId: delivery.recordUserId,
+      recipientUserId: delivery.recipientUserId,
+    };
     const channels = await prisma.notificationChannel.findMany({
-      where: { userId: payload.userId, enabled: true },
+      where: { userId: delivery.recipientUserId, enabled: true },
       include: {
         preferences: {
-          where: { eventType: payload.eventType },
+          where: { eventType: deliveryPayload.eventType },
         },
       },
     });
@@ -79,7 +90,7 @@ export async function dispatchNotification(
     if (!hasTelegramChannel) {
       try {
         const user = await prisma.user.findUnique({
-          where: { id: payload.userId },
+          where: { id: delivery.recipientUserId },
           select: {
             telegramBotToken: true,
             telegramChatId: true,
@@ -101,12 +112,12 @@ export async function dispatchNotification(
           const created = await prisma.notificationChannel.upsert({
             where: {
               userId_type: {
-                userId: payload.userId,
+                userId: delivery.recipientUserId,
                 type: "TELEGRAM",
               },
             },
             create: {
-              userId: payload.userId,
+              userId: delivery.recipientUserId,
               type: "TELEGRAM",
               enabled: true,
               config: channelConfig,
@@ -117,13 +128,16 @@ export async function dispatchNotification(
             },
             include: {
               preferences: {
-                where: { eventType: payload.eventType },
+                where: { eventType: deliveryPayload.eventType },
               },
             },
           });
 
           channels.push(created);
-          getEvent()?.addMeta("telegram_legacy_migration", payload.userId);
+          getEvent()?.addMeta(
+            "telegram_legacy_migration",
+            delivery.recipientUserId,
+          );
         }
       } catch (err) {
         getEvent()?.addWarning(`Legacy Telegram migration failed: ${err}`);
@@ -145,7 +159,7 @@ export async function dispatchNotification(
     // from /settings/notifications once they've seen the badge a few
     // times and decided they want push.
     let defaultEnabled =
-      EVENT_DEFAULT_ENABLED[payload.eventType as EventType] ?? true;
+      EVENT_DEFAULT_ENABLED[deliveryPayload.eventType as EventType] ?? true;
 
     // v1.7.0 — MOOD_REMINDER single source of truth = the visible card.
     // The event used to default OFF, layered on top of the per-user
@@ -156,9 +170,9 @@ export async function dispatchNotification(
     // opt-out (a `NotificationPreference` row with `enabled = false`) is
     // still honoured below via `pref.enabled` — only the no-row default
     // is derived from the card.
-    if (payload.eventType === "MOOD_REMINDER") {
+    if (deliveryPayload.eventType === "MOOD_REMINDER") {
       const user = await prisma.user.findUnique({
-        where: { id: payload.userId },
+        where: { id: delivery.recipientUserId },
         select: { moodReminderEnabled: true },
       });
       defaultEnabled = user?.moodReminderEnabled === true;
@@ -170,13 +184,13 @@ export async function dispatchNotification(
     let clientManagedApns: boolean | null = null;
     const resolveClientManagedApns = async (): Promise<boolean> => {
       if (clientManagedApns !== null) return clientManagedApns;
-      const gate = CLIENT_MANAGED_APNS_EVENTS[payload.eventType];
+      const gate = CLIENT_MANAGED_APNS_EVENTS[deliveryPayload.eventType];
       if (!gate) {
         clientManagedApns = false;
         return false;
       }
       const row = await prisma.user.findUnique({
-        where: { id: payload.userId },
+        where: { id: delivery.recipientUserId },
         select: { notificationPrefs: true },
       });
       clientManagedApns = gate.isClientManaged(row?.notificationPrefs);
@@ -209,21 +223,23 @@ export async function dispatchNotification(
       // about whether anything actually reached the user.
       if (
         channel.type === "APNS" &&
-        hasClientManagedApnsGate(payload.eventType) &&
+        !delivery.managed &&
+        hasClientManagedApnsGate(deliveryPayload.eventType) &&
         (await resolveClientManagedApns())
       ) {
-        const gate = CLIENT_MANAGED_APNS_EVENTS[payload.eventType];
-        getEvent()?.addMeta(gate.metaKey, gate.tag(payload.metadata));
+        const gate = CLIENT_MANAGED_APNS_EVENTS[deliveryPayload.eventType];
+        getEvent()?.addMeta(gate.metaKey, gate.tag(deliveryPayload.metadata));
         if (gate.detail && gate.detailKey) {
           getEvent()?.addMeta(
             gate.detailKey,
-            gate.detail(payload.userId, payload.metadata),
+            gate.detail(deliveryPayload.userId, deliveryPayload.metadata),
           );
         }
         recordPushAttempt({
-          userId: payload.userId,
+          recordUserId: delivery.recordUserId,
+          recipientUserId: delivery.recipientUserId,
           channel: "APNS",
-          eventType: payload.eventType,
+          eventType: deliveryPayload.eventType,
           result: "skipped",
           reason: "client_managed",
         });
@@ -236,7 +252,8 @@ export async function dispatchNotification(
         const outcome = await sendToChannel(
           channel.type as ChannelType,
           channel.config,
-          payload,
+          delivery.recipientUserId,
+          deliveryPayload,
         );
 
         if (outcome.ok) {
@@ -310,6 +327,7 @@ export async function dispatchNotification(
 async function sendToChannel(
   type: ChannelType,
   encryptedConfig: string,
+  recipientUserId: string,
   payload: NotificationPayload,
 ): Promise<SendOutcome> {
   let decrypted: string;
@@ -393,7 +411,7 @@ async function sendToChannel(
       return sendViaEmail(config, payload);
     }
     case "WEB_PUSH": {
-      return sendViaWebPush(payload.userId, payload);
+      return sendViaWebPush(recipientUserId, payload);
     }
     case "APNS": {
       // APNs config lives on the Device row, not in the channel config.
@@ -401,7 +419,7 @@ async function sendToChannel(
       // we just keep the symmetric path so future per-user overrides
       // (e.g. a custom APNs topic) can hang off the channel without
       // changing the dispatcher shape.
-      return sendViaApns(payload.userId, payload);
+      return sendViaApns(recipientUserId, payload);
     }
     default:
       getEvent()?.addWarning(`Unknown notification channel type: ${type}`);
diff --git a/src/lib/notifications/reminder-dedup.ts b/src/lib/notifications/reminder-dedup.ts
index 014ee3512..16f5ee741 100644
--- a/src/lib/notifications/reminder-dedup.ts
+++ b/src/lib/notifications/reminder-dedup.ts
@@ -8,9 +8,9 @@
  * ntfy had no row, so the tick re-sent the same overdue notice on every
  * pass for the rest of the local day.
  *
- * The anchor now lives in `push_attempts`, the ledger the daily briefing
- * and the illness escalation already use for the same purpose. Two
- * properties matter and both are deliberate:
+ * The anchor now lives in `notification_events`, a record-scoped event ledger
+ * rather than a channel delivery record. Three properties matter and all are
+ * deliberate:
  *
  *  - **Written per dispatched slot, not per successful send.** Anchoring
  *    on a delivered push would re-open the flood the moment a channel
@@ -18,27 +18,20 @@
  *  - **Written before the dispatch.** A crash mid-dispatch burns the slot
  *    for that phase rather than risking a repeat; the next phase still
  *    escalates, and the next local day starts clean.
+ *  - **Claimed atomically.** A transaction-scoped advisory lock serializes
+ *    same-key workers through the window check and append, while provider
+ *    egress remains outside that short transaction.
  *
- * The rows are bookkeeping, not delivery attempts, so they carry the
- * `DEDUP` channel sentinel and the operator-facing notification surfaces
- * filter them out.
  */
 import type { PrismaClient } from "@/generated/prisma/client";
 
-/**
- * Channel sentinel for a bookkeeping row. Never a real delivery target —
- * `/api/admin/notifications/{health,diagnostic}` exclude it so the
- * per-channel health picture stays a picture of actual sends.
- */
-export const REMINDER_DEDUP_CHANNEL = "DEDUP";
-
 /**
  * How far back the anchor lookup reads. The key already carries the local
  * date, so anything older than this cannot match; the bound exists to keep
- * the read on the `(user_id, created_at DESC)` index. Two days covers every
- * timezone offset plus a DST shift.
+ * the read on the record/event/key index. Two days covers every timezone
+ * offset plus a DST shift.
  */
-const ANCHOR_LOOKBACK_MS = 48 * 60 * 60 * 1000;
+export const REMINDER_DEDUP_LOOKBACK_MS = 48 * 60 * 60 * 1000;
 
 /**
  * Dedup key for one medication dose slot in one phase on one local day.
@@ -69,51 +62,59 @@ export function medicationReminderDedupKey(input: {
 }
 
 /**
- * Has this exact slot+phase+day already been dispatched? Best-effort: a DB
- * error biases toward "not yet", so a transient blip delays nothing — the
- * cost of a rare duplicate is far below the cost of a silently dropped
- * dose reminder.
+ * Atomically claim a record-scoped notification event within one rolling
+ * window. A `true` result is the sole permission to continue to provider
+ * egress; `false` means another worker already claimed it or the database
+ * could not establish the claim. The advisory lock, lookup, and append stay
+ * inside the short transaction. Callers always perform delivery afterward.
  */
-export async function hasReminderDedupAnchor(
+export async function claimNotificationEvent(
   prisma: PrismaClient,
-  input: { userId: string; eventType: string; reason: string; now: Date },
+  input: {
+    recordUserId: string;
+    eventType: string;
+    dedupKey: string;
+    since: Date;
+  },
 ): Promise<boolean> {
   try {
-    const row = await prisma.pushAttempt.findFirst({
-      where: {
-        userId: input.userId,
-        eventType: input.eventType,
-        reason: input.reason,
-        createdAt: { gte: new Date(input.now.getTime() - ANCHOR_LOOKBACK_MS) },
-      },
-      select: { id: true },
+    return await prisma.$transaction(async (tx) => {
+      const lockKey = [
+        "notification-event",
+        input.recordUserId,
+        input.eventType,
+        input.dedupKey,
+      ].join(":");
+      await tx.$queryRaw`
+        SELECT 1 AS locked
+        FROM pg_advisory_xact_lock(hashtextextended(${lockKey}, 0))
+      `;
+
+      const existing = await tx.notificationEvent.findFirst({
+        where: {
+          recordUserId: input.recordUserId,
+          eventType: input.eventType,
+          dedupKey: input.dedupKey,
+          createdAt: { gte: input.since },
+        },
+        orderBy: { createdAt: "desc" },
+        select: { id: true },
+      });
+      if (existing) return false;
+
+      await tx.notificationEvent.create({
+        data: {
+          recordUserId: input.recordUserId,
+          eventType: input.eventType,
+          dedupKey: input.dedupKey,
+        },
+      });
+      return true;
     });
-    return row !== null;
   } catch {
+    // Fail closed: a worker that cannot durably claim the event must not
+    // contact a provider. A later tick may retry after the transaction rolls
+    // back, so an outage delays rather than duplicates a notification.
     return false;
   }
 }
-
-/**
- * Stamp the anchor. Never throws — a failed stamp costs a duplicate
- * notification at the next tick, while a thrown error would cost the
- * dispatch itself.
- */
-export async function writeReminderDedupAnchor(
-  prisma: PrismaClient,
-  input: { userId: string; eventType: string; reason: string },
-): Promise<void> {
-  try {
-    await prisma.pushAttempt.create({
-      data: {
-        userId: input.userId,
-        channel: REMINDER_DEDUP_CHANNEL,
-        eventType: input.eventType,
-        result: "skipped",
-        reason: input.reason,
-      },
-    });
-  } catch {
-    // Best-effort by contract; the next tick re-derives the same slot.
-  }
-}
diff --git a/src/lib/notifications/senders/__tests__/email.test.ts b/src/lib/notifications/senders/__tests__/email.test.ts
index 5abbb7cd9..998ec15f6 100644
--- a/src/lib/notifications/senders/__tests__/email.test.ts
+++ b/src/lib/notifications/senders/__tests__/email.test.ts
@@ -31,6 +31,11 @@ vi.mock("@/lib/logging/context", () => ({
 
 vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
   recordPushAttempt: (...args: unknown[]) => recordPushAttemptMock(...args),
+  recordPushAttemptForPayload: (
+    _payload: unknown,
+    _recipientUserId: string,
+    attempt: unknown,
+  ) => recordPushAttemptMock(attempt),
 }));
 
 import { sendViaEmail, resetEmailTransporterForTesting } from "../email";
diff --git a/src/lib/notifications/senders/__tests__/push-attempt-record.test.ts b/src/lib/notifications/senders/__tests__/push-attempt-record.test.ts
index eda7a445d..85d048094 100644
--- a/src/lib/notifications/senders/__tests__/push-attempt-record.test.ts
+++ b/src/lib/notifications/senders/__tests__/push-attempt-record.test.ts
@@ -41,6 +41,7 @@ const hoisted = vi.hoisted(() => ({
   webPushGenerateRequestDetailsMock: vi.fn(),
   sendTelegramMessageMock: vi.fn(),
   deleteTelegramMessageMock: vi.fn(),
+  addWarningMock: vi.fn(),
 }));
 
 vi.mock("@parse/node-apn", () => {
@@ -98,7 +99,7 @@ vi.mock("@/lib/crypto", () => ({
 vi.mock("@/lib/logging/context", () => ({
   getEvent: () => ({
     addExternalCall: vi.fn(),
-    addWarning: vi.fn(),
+    addWarning: hoisted.addWarningMock,
     setError: vi.fn(),
   }),
 }));
@@ -142,6 +143,7 @@ import {
 import { sendViaWebPush } from "@/lib/notifications/senders/web-push";
 import { sendViaTelegram } from "@/lib/notifications/senders/telegram";
 import { sendViaNtfy } from "@/lib/notifications/senders/ntfy";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { prisma } from "@/lib/db";
 
 const TEST_EC_PEM_LINES = [
@@ -218,6 +220,31 @@ async function flushMicrotasks(): Promise<void> {
   await new Promise((resolve) => setImmediate(resolve));
 }
 
+describe("recordPushAttemptForPayload — attribution boundary", () => {
+  it("rejects a partial delivery identity without writing a ledger row", async () => {
+    recordPushAttemptForPayload({ recordUserId: "record-1" }, "recipient-1", {
+      channel: "TELEGRAM",
+      eventType: "MEDICATION_REMINDER",
+      result: "ok",
+    });
+    recordPushAttemptForPayload(
+      { recipientUserId: "recipient-1" },
+      "recipient-1",
+      {
+        channel: "TELEGRAM",
+        eventType: "MEDICATION_REMINDER",
+        result: "ok",
+      },
+    );
+    await flushMicrotasks();
+
+    expect(prisma.pushAttempt.create).not.toHaveBeenCalled();
+    expect(hoisted.addWarningMock).toHaveBeenCalledWith(
+      "push_attempt_ledger_write_failed invalid_attribution",
+    );
+  });
+});
+
 describe("recordPushAttempt — APNS sender", () => {
   it("writes one ok row when the dispatch succeeds", async () => {
     vi.mocked(prisma.device.findMany).mockResolvedValue([
diff --git a/src/lib/notifications/senders/__tests__/telegram.test.ts b/src/lib/notifications/senders/__tests__/telegram.test.ts
index 9439062dd..292900143 100644
--- a/src/lib/notifications/senders/__tests__/telegram.test.ts
+++ b/src/lib/notifications/senders/__tests__/telegram.test.ts
@@ -2,8 +2,9 @@
  * Telegram sender unit tests.
  *
  * v1.7.0 SB-SCHED-4 / code-correctness H2 — the pre-send delete must be
- * scoped to the single dose slot `{ medicationId, scheduleId, date,
- * phase, timeOfDay }`, NOT the whole medication. A multi-time-of-day
+ * scoped to the recipient and single dose slot `{ recipientUserId,
+ * medicationId, scheduleId, date, phase, timeOfDay }`, NOT the whole
+ * medication. A multi-time-of-day
  * schedule keeps a distinct ledger row per slot; the legacy whole-
  * medication wipe deleted the morning row when the evening slot fired,
  * which made the worker's dedup `findUnique` miss and re-send the
@@ -14,7 +15,6 @@ import { afterEach, beforeEach, describe, expect, it, vi } from "vitest";
 const sendTelegramMessageMock = vi.fn();
 const deleteMessageMock = vi.fn();
 const findUniqueMock = vi.fn();
-const deleteMock = vi.fn();
 const upsertMock = vi.fn();
 const userFindUniqueMock = vi.fn();
 
@@ -30,7 +30,6 @@ vi.mock("@/lib/db", () => ({
     },
     telegramReminderMessage: {
       findUnique: (...args: unknown[]) => findUniqueMock(...args),
-      delete: (...args: unknown[]) => deleteMock(...args),
       upsert: (...args: unknown[]) => upsertMock(...args),
     },
   },
@@ -42,6 +41,7 @@ vi.mock("@/lib/logging/context", () => ({
 
 vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
   recordPushAttempt: vi.fn(),
+  recordPushAttemptForPayload: vi.fn(),
 }));
 
 const scheduleTelegramAutoDeleteMock = vi.fn();
@@ -77,7 +77,6 @@ describe("sendViaTelegram — per-slot delete scope (H2)", () => {
     sendTelegramMessageMock.mockResolvedValue({ ok: true, messageId: 999 });
     deleteMessageMock.mockResolvedValue(undefined);
     findUniqueMock.mockResolvedValue(null);
-    deleteMock.mockResolvedValue(undefined);
     upsertMock.mockResolvedValue(undefined);
     userFindUniqueMock.mockResolvedValue({ locale: "en" });
     scheduleTelegramAutoDeleteMock.mockResolvedValue(undefined);
@@ -93,7 +92,8 @@ describe("sendViaTelegram — per-slot delete scope (H2)", () => {
     expect(findUniqueMock).toHaveBeenCalledTimes(1);
     expect(findUniqueMock).toHaveBeenCalledWith({
       where: {
-        medicationId_scheduleId_date_phase_timeOfDay: {
+        recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+          recipientUserId: "user-1",
           medicationId: "med-1",
           scheduleId: "sched-1",
           date: "2025-06-10",
@@ -104,7 +104,7 @@ describe("sendViaTelegram — per-slot delete scope (H2)", () => {
     });
   });
 
-  it("deletes only the matching slot's ledger row, leaving sibling slots untouched", async () => {
+  it("replaces only the matching slot's remote message, leaving its tracking row for update", async () => {
     // The 20:00 slot has a prior row; the lookup returns it.
     findUniqueMock.mockResolvedValue({
       chatId: "chat-1",
@@ -115,19 +115,22 @@ describe("sendViaTelegram — per-slot delete scope (H2)", () => {
 
     // The Telegram message for the old 20:00 row is deleted...
     expect(deleteMessageMock).toHaveBeenCalledWith("bot-token", "chat-1", 123);
-    // ...and exactly that single ledger row is removed (scoped delete, not deleteMany).
-    expect(deleteMock).toHaveBeenCalledTimes(1);
-    expect(deleteMock).toHaveBeenCalledWith({
-      where: {
-        medicationId_scheduleId_date_phase_timeOfDay: {
-          medicationId: "med-1",
-          scheduleId: "sched-1",
-          date: "2025-06-10",
-          phase: "YELLOW",
-          timeOfDay: "20:00",
+    // The tracking row stays in place so the recipient-scoped upsert updates
+    // it rather than creating a second row when the chat binding changes.
+    expect(upsertMock).toHaveBeenCalledWith(
+      expect.objectContaining({
+        where: {
+          recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+            recipientUserId: "user-1",
+            medicationId: "med-1",
+            scheduleId: "sched-1",
+            date: "2025-06-10",
+            phase: "YELLOW",
+            timeOfDay: "20:00",
+          },
         },
-      },
-    });
+      }),
+    );
   });
 
   it("does not delete anything when no prior row exists for the slot", async () => {
@@ -136,7 +139,6 @@ describe("sendViaTelegram — per-slot delete scope (H2)", () => {
     await sendViaTelegram(config, reminderPayload());
 
     expect(deleteMessageMock).not.toHaveBeenCalled();
-    expect(deleteMock).not.toHaveBeenCalled();
     // It still sends + tracks the new message.
     expect(sendTelegramMessageMock).toHaveBeenCalledTimes(1);
     expect(upsertMock).toHaveBeenCalledTimes(1);
@@ -151,7 +153,81 @@ describe("sendViaTelegram — per-slot delete scope (H2)", () => {
     );
 
     expect(findUniqueMock).not.toHaveBeenCalled();
-    expect(deleteMock).not.toHaveBeenCalled();
+  });
+
+  it("keeps two recipients' identical subject slots independent", async () => {
+    await sendViaTelegram(
+      { botToken: "bot-token", chatId: "guardian-chat-a" },
+      {
+        ...reminderPayload(),
+        userId: "managed-record",
+        recordUserId: "managed-record",
+        recipientUserId: "guardian-a",
+      },
+    );
+    await sendViaTelegram(
+      { botToken: "bot-token", chatId: "guardian-chat-b" },
+      {
+        ...reminderPayload(),
+        userId: "managed-record",
+        recordUserId: "managed-record",
+        recipientUserId: "guardian-b",
+      },
+    );
+
+    expect(upsertMock).toHaveBeenCalledTimes(2);
+    expect(upsertMock.mock.calls.map((call) => call[0].where)).toEqual([
+      {
+        recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+          recipientUserId: "guardian-a",
+          medicationId: "med-1",
+          scheduleId: "sched-1",
+          date: "2025-06-10",
+          phase: "YELLOW",
+          timeOfDay: "20:00",
+        },
+      },
+      {
+        recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+          recipientUserId: "guardian-b",
+          medicationId: "med-1",
+          scheduleId: "sched-1",
+          date: "2025-06-10",
+          phase: "YELLOW",
+          timeOfDay: "20:00",
+        },
+      },
+    ]);
+  });
+
+  it("updates one recipient slot when its Telegram chat changes", async () => {
+    findUniqueMock.mockResolvedValue({ chatId: "old-chat", messageId: 123 });
+
+    await sendViaTelegram(
+      { botToken: "bot-token", chatId: "new-chat" },
+      reminderPayload(),
+    );
+
+    expect(deleteMessageMock).toHaveBeenCalledWith(
+      "bot-token",
+      "old-chat",
+      123,
+    );
+    expect(upsertMock).toHaveBeenCalledWith(
+      expect.objectContaining({
+        where: {
+          recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+            recipientUserId: "user-1",
+            medicationId: "med-1",
+            scheduleId: "sched-1",
+            date: "2025-06-10",
+            phase: "YELLOW",
+            timeOfDay: "20:00",
+          },
+        },
+        update: { chatId: "new-chat", messageId: 999 },
+      }),
+    );
   });
 });
 
diff --git a/src/lib/notifications/senders/__tests__/urgency.test.ts b/src/lib/notifications/senders/__tests__/urgency.test.ts
index e23a15f44..bf94783ac 100644
--- a/src/lib/notifications/senders/__tests__/urgency.test.ts
+++ b/src/lib/notifications/senders/__tests__/urgency.test.ts
@@ -35,6 +35,11 @@ vi.mock("@/lib/logging/context", () => ({
 
 vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
   recordPushAttempt: (...args: unknown[]) => recordPushAttemptMock(...args),
+  recordPushAttemptForPayload: (
+    _payload: unknown,
+    _recipientUserId: string,
+    attempt: unknown,
+  ) => recordPushAttemptMock(attempt),
 }));
 
 vi.mock("@/lib/db", () => ({
diff --git a/src/lib/notifications/senders/__tests__/webhook.test.ts b/src/lib/notifications/senders/__tests__/webhook.test.ts
index eaddccc2b..aab98366d 100644
--- a/src/lib/notifications/senders/__tests__/webhook.test.ts
+++ b/src/lib/notifications/senders/__tests__/webhook.test.ts
@@ -27,6 +27,11 @@ vi.mock("@/lib/logging/context", () => ({
 
 vi.mock("@/lib/notifications/senders/push-attempt-record", () => ({
   recordPushAttempt: (...args: unknown[]) => recordPushAttemptMock(...args),
+  recordPushAttemptForPayload: (
+    _payload: unknown,
+    _recipientUserId: string,
+    attempt: unknown,
+  ) => recordPushAttemptMock(attempt),
 }));
 
 import { sendViaWebhook } from "../webhook";
diff --git a/src/lib/notifications/senders/apns.ts b/src/lib/notifications/senders/apns.ts
index 07fe39a75..a614004bd 100644
--- a/src/lib/notifications/senders/apns.ts
+++ b/src/lib/notifications/senders/apns.ts
@@ -29,7 +29,7 @@ import apn from "@parse/node-apn";
 import { prisma } from "@/lib/db";
 import { getEvent } from "@/lib/logging/context";
 import type { SendOutcome } from "@/lib/notifications/retry-policy";
-import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { plainPushText } from "@/lib/notifications/strip-emoji";
 
 export interface ApnsPayload {
@@ -532,11 +532,13 @@ export async function sendViaApns(
     metadata?: Record<string, unknown>;
     discreet?: boolean;
     urgent?: boolean;
+    recordUserId?: string;
+    recipientUserId?: string;
   },
 ): Promise<SendOutcome> {
   const config = loadApnsConfig();
   if (!config) {
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId,
       channel: "APNS",
       eventType: payload.eventType,
@@ -565,7 +567,7 @@ export async function sendViaApns(
   if (devices.length === 0) {
     // Same rationale as web-push: a user who hasn't paired an iPhone yet
     // shouldn't see the channel auto-disabled. Treat as soft "no recipient".
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId,
       channel: "APNS",
       eventType: payload.eventType,
@@ -626,6 +628,10 @@ export async function sendViaApns(
       process.env.APNS_CRITICAL_ENTITLEMENT === "true";
 
     let result: Awaited<ReturnType<typeof sendApnsPush>> | null = null;
+    const managedDelivery =
+      payload.recordUserId !== undefined &&
+      payload.recipientUserId !== undefined &&
+      payload.recordUserId !== payload.recipientUserId;
     // Discreet mode (cycle privacy): the lock-screen-visible routing
     // metadata must not carry the event name. Collapse the category /
     // threadId / collapseId and the data eventType to a generic value so
@@ -677,7 +683,7 @@ export async function sendViaApns(
           // ignores categories it doesn't know about, so adding the key
           // here is safe for event-types that don't have an actionable
           // category registered yet — they fall back to a plain alert.
-          category: routingEvent,
+          category: managedDelivery ? undefined : routingEvent,
           // Future-proof for an iOS Notification Service Extension. iOS
           // ignores the flag when no extension is registered, so it's a
           // no-op on today's binary but unblocks NSE work without a
@@ -742,7 +748,7 @@ export async function sendViaApns(
   }
 
   if (anySuccess) {
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId,
       channel: "APNS",
       eventType: payload.eventType,
@@ -755,7 +761,7 @@ export async function sendViaApns(
   // until the user re-registers from a fresh iOS install.
   if (deadDeviceIds.length === devices.length) {
     const reason = lastFailureReason ?? "apns_all_devices_unregistered";
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId,
       channel: "APNS",
       eventType: payload.eventType,
@@ -771,7 +777,7 @@ export async function sendViaApns(
   }
 
   const reason = lastFailureReason ?? "apns_send_failed";
-  recordPushAttempt({
+  recordPushAttemptForPayload(payload, userId, {
     userId,
     channel: "APNS",
     eventType: payload.eventType,
diff --git a/src/lib/notifications/senders/email.ts b/src/lib/notifications/senders/email.ts
index b072cb90b..813a1660a 100644
--- a/src/lib/notifications/senders/email.ts
+++ b/src/lib/notifications/senders/email.ts
@@ -7,7 +7,7 @@ import type {
 } from "@/lib/notifications/types";
 import type { SendOutcome } from "@/lib/notifications/retry-policy";
 import { getEvent } from "@/lib/logging/context";
-import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { loadEmailConfig } from "@/lib/notifications/senders/email-config";
 import { plainPushText } from "@/lib/notifications/strip-emoji";
 
@@ -97,12 +97,13 @@ export async function sendViaEmail(
   config: EmailChannelConfig,
   payload: NotificationPayload,
 ): Promise<SendOutcome> {
+  const userId = payload.recipientUserId ?? payload.userId;
   const start = performance.now();
 
   const transport = getTransporter();
   if (!transport) {
     // Operator hasn't configured SMTP — soft skip, no channel burn.
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "EMAIL",
       eventType: payload.eventType,
@@ -113,7 +114,7 @@ export async function sendViaEmail(
   }
 
   if (!config.recipient) {
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "EMAIL",
       eventType: payload.eventType,
@@ -143,7 +144,7 @@ export async function sendViaEmail(
       method: "sendMail",
       duration_ms: Math.round(performance.now() - start),
     });
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "EMAIL",
       eventType: payload.eventType,
@@ -158,7 +159,7 @@ export async function sendViaEmail(
       duration_ms: Math.round(performance.now() - start),
       error: classified.message,
     });
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "EMAIL",
       eventType: payload.eventType,
diff --git a/src/lib/notifications/senders/ntfy.ts b/src/lib/notifications/senders/ntfy.ts
index 7a673f974..ade424ac6 100644
--- a/src/lib/notifications/senders/ntfy.ts
+++ b/src/lib/notifications/senders/ntfy.ts
@@ -5,7 +5,7 @@ import type {
 import type { SendOutcome } from "@/lib/notifications/retry-policy";
 import { classifyHttpStatus } from "@/lib/notifications/retry-policy";
 import { getEvent } from "@/lib/logging/context";
-import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { safeFetch } from "@/lib/safe-fetch";
 import { plainPushText } from "@/lib/notifications/strip-emoji";
 import { isUrgentPayload } from "@/lib/notifications/types";
@@ -23,6 +23,7 @@ export async function sendViaNtfy(
   config: NtfyChannelConfig,
   payload: NotificationPayload,
 ): Promise<SendOutcome> {
+  const userId = payload.recipientUserId ?? payload.userId;
   const start = performance.now();
   try {
     const url = `${config.serverUrl.replace(/\/$/, "")}/${encodeURIComponent(config.topic)}`;
@@ -84,7 +85,7 @@ export async function sendViaNtfy(
     });
 
     if (res.ok) {
-      recordPushAttempt({
+      recordPushAttemptForPayload(payload, userId, {
         userId: payload.userId,
         channel: "NTFY",
         eventType: payload.eventType,
@@ -93,7 +94,7 @@ export async function sendViaNtfy(
       return { ok: true, statusCode: res.status };
     }
     const classified = classifyHttpStatus(res.status, "ntfy");
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "NTFY",
       eventType: payload.eventType,
@@ -114,7 +115,7 @@ export async function sendViaNtfy(
       duration_ms: Math.round(performance.now() - start),
       error: message,
     });
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "NTFY",
       eventType: payload.eventType,
diff --git a/src/lib/notifications/senders/push-attempt-record.ts b/src/lib/notifications/senders/push-attempt-record.ts
index 78b9bfcac..e4a2ba070 100644
--- a/src/lib/notifications/senders/push-attempt-record.ts
+++ b/src/lib/notifications/senders/push-attempt-record.ts
@@ -1,5 +1,6 @@
 import { prisma } from "@/lib/db";
 import { getEvent } from "@/lib/logging/context";
+import type { NotificationPayload } from "@/lib/notifications/types";
 
 /**
  * v1.4.49 — fire-and-forget push-attempt ledger write.
@@ -31,22 +32,93 @@ import { getEvent } from "@/lib/logging/context";
  *                    the sender contracts surface without contacting
  *                    the upstream provider.
  */
-export interface PushAttemptRecord {
-  userId: string;
+interface PushAttemptRecordBase {
   channel: "APNS" | "WEB_PUSH" | "TELEGRAM" | "NTFY" | "WEBHOOK" | "EMAIL";
   eventType: string;
   result: "ok" | "error" | "skipped";
   reason?: string | null;
 }
 
+/** Existing self-delivery callers map the record and recipient to one account. */
+interface SelfPushAttemptRecord extends PushAttemptRecordBase {
+  userId: string;
+  recordUserId?: never;
+  recipientUserId?: never;
+}
+
+/** Managed delivery always supplies both principals without inference. */
+interface AttributedPushAttemptRecord extends PushAttemptRecordBase {
+  userId?: never;
+  recordUserId: string;
+  recipientUserId: string;
+}
+
+export type PushAttemptRecord =
+  SelfPushAttemptRecord | AttributedPushAttemptRecord;
+
+/**
+ * Preserve the supplied record subject while a sender records delivery for
+ * the recipient selected by the dispatcher. The legacy `userId` property in
+ * sender call sites is deliberately ignored here: 0298 stores it as a
+ * recipient mirror and the explicit pair is authoritative.
+ */
+export function recordPushAttemptForPayload(
+  payload: Pick<NotificationPayload, "recordUserId" | "recipientUserId">,
+  legacyUserId: string,
+  record: PushAttemptRecordBase & { userId?: string },
+): void {
+  const hasRecordUserId = payload.recordUserId !== undefined;
+  const hasRecipientUserId = payload.recipientUserId !== undefined;
+
+  if (hasRecordUserId !== hasRecipientUserId) {
+    getEvent()?.addWarning(
+      "push_attempt_ledger_write_failed invalid_attribution",
+    );
+    return;
+  }
+
+  if (!hasRecordUserId) {
+    recordPushAttempt({
+      userId: legacyUserId,
+      channel: record.channel,
+      eventType: record.eventType,
+      result: record.result,
+      reason: record.reason,
+    });
+    return;
+  }
+
+  recordPushAttempt({
+    recordUserId: payload.recordUserId!,
+    recipientUserId: payload.recipientUserId!,
+    channel: record.channel,
+    eventType: record.eventType,
+    result: record.result,
+    reason: record.reason,
+  });
+}
+
 export function recordPushAttempt(record: PushAttemptRecord): void {
+  const recordUserId = "userId" in record ? record.userId : record.recordUserId;
+  const recipientUserId =
+    "userId" in record ? record.userId : record.recipientUserId;
+
+  if (!recordUserId || !recipientUserId) {
+    getEvent()?.addWarning(
+      "push_attempt_ledger_write_failed invalid_attribution",
+    );
+    return;
+  }
+
   // The `void` here is the doubly-explicit form: we want neither the
   // caller nor a linter to wait on this promise. The `.catch` traps
   // a rejected promise without surfacing it to the caller.
   void prisma.pushAttempt
     .create({
       data: {
-        userId: record.userId,
+        userId: recipientUserId,
+        recordUserId,
+        recipientUserId,
         channel: record.channel,
         eventType: record.eventType,
         result: record.result,
diff --git a/src/lib/notifications/senders/telegram.ts b/src/lib/notifications/senders/telegram.ts
index b31f9f6de..8a2bf2479 100644
--- a/src/lib/notifications/senders/telegram.ts
+++ b/src/lib/notifications/senders/telegram.ts
@@ -8,7 +8,7 @@ import { classifyTelegramError } from "@/lib/notifications/retry-policy";
 import { prisma } from "@/lib/db";
 import type { ReminderPhase } from "@/generated/prisma/client";
 import { getEvent } from "@/lib/logging/context";
-import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { scheduleTelegramAutoDelete } from "@/lib/telegram-cleanup";
 import {
   buildMoodKeyboard,
@@ -18,8 +18,8 @@ import { defaultLocale, locales, type Locale } from "@/lib/i18n/config";
 
 /**
  * v1.19.0 — resolve the bot locale for an interactive reminder. The
- * sender knows the user via `payload.userId`; the keyboard labels need
- * the user's locale. Defaults to "de" (the historical bot default) when
+ * sender knows the recipient through the delivery identity; keyboard labels
+ * need that account's locale. Defaults to "de" when
  * unset, matching the webhook's `resolveBotLocale`.
  */
 async function resolveSenderLocale(userId: string): Promise<Locale> {
@@ -52,7 +52,7 @@ export interface TelegramSendResult extends SendOutcome {
 /**
  * Delete the existing Telegram reminder message for a single dose slot
  * before re-sending it. v1.7.0 SB-SCHED-4 — scoped to the exact slot
- * `{ medicationId, scheduleId, date, phase, timeOfDay }` (the same
+ * `{ recipientUserId, medicationId, scheduleId, date, phase, timeOfDay }` (the same
  * composite the tracking upsert keys on), NOT the whole medication. A
  * medication with `timesOfDay = ["08:00","20:00"]` has two distinct
  * ledger rows per day; the pre-v1.7 whole-medication wipe deleted the
@@ -62,6 +62,7 @@ export interface TelegramSendResult extends SendOutcome {
  */
 async function deleteExistingReminders(
   botToken: string,
+  recipientUserId: string,
   medicationId: string,
   scheduleId: string,
   date: string,
@@ -71,7 +72,8 @@ async function deleteExistingReminders(
   try {
     const existing = await prisma.telegramReminderMessage.findUnique({
       where: {
-        medicationId_scheduleId_date_phase_timeOfDay: {
+        recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+          recipientUserId,
           medicationId,
           scheduleId,
           date,
@@ -88,18 +90,6 @@ async function deleteExistingReminders(
     } catch {
       // Best-effort: message may already be deleted
     }
-
-    await prisma.telegramReminderMessage.delete({
-      where: {
-        medicationId_scheduleId_date_phase_timeOfDay: {
-          medicationId,
-          scheduleId,
-          date,
-          phase,
-          timeOfDay,
-        },
-      },
-    });
   } catch (err) {
     getEvent()?.addWarning(`Failed to delete existing reminders: ${err}`);
   }
@@ -118,6 +108,7 @@ export async function sendViaTelegram(
   config: TelegramChannelConfig,
   payload: NotificationPayload,
 ): Promise<TelegramSendResult> {
+  const userId = payload.recipientUserId ?? payload.userId;
   const medicationId = payload.metadata?.medicationId as string | undefined;
   const scheduleId = payload.metadata?.scheduleId as string | undefined;
   const phase = payload.metadata?.phase as string | undefined;
@@ -135,6 +126,7 @@ export async function sendViaTelegram(
   if (medicationId && scheduleId && phase && date) {
     await deleteExistingReminders(
       config.botToken,
+      userId,
       medicationId,
       scheduleId,
       date,
@@ -152,24 +144,25 @@ export async function sendViaTelegram(
   let interactiveKeyboard:
     | { inline_keyboard: { text: string; callback_data: string }[][] }
     | undefined;
-  if (!replyMarkup) {
+  const selfDelivery = payload.recordUserId === payload.recipientUserId;
+  if (selfDelivery && !replyMarkup) {
     if (payload.eventType === "MOOD_REMINDER") {
       interactiveKeyboard = buildMoodKeyboard(
-        await resolveSenderLocale(payload.userId),
+        await resolveSenderLocale(userId),
       );
     } else if (payload.eventType === "MEASUREMENT_REMINDER" && reminderId) {
       interactiveKeyboard = buildMeasurementKeyboard(
         reminderId,
-        await resolveSenderLocale(payload.userId),
+        await resolveSenderLocale(userId),
       );
     }
   }
 
   // Build reply markup
   const keyboard =
-    replyMarkup ??
+    (selfDelivery ? replyMarkup : undefined) ??
     interactiveKeyboard ??
-    (payload.eventType === "MEDICATION_REMINDER" && medicationId
+    (selfDelivery && payload.eventType === "MEDICATION_REMINDER" && medicationId
       ? {
           inline_keyboard: [
             [
@@ -218,7 +211,8 @@ export async function sendViaTelegram(
     try {
       await prisma.telegramReminderMessage.upsert({
         where: {
-          medicationId_scheduleId_date_phase_timeOfDay: {
+          recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+            recipientUserId: userId,
             medicationId,
             scheduleId,
             date,
@@ -227,6 +221,7 @@ export async function sendViaTelegram(
           },
         },
         create: {
+          recipientUserId: userId,
           medicationId,
           scheduleId,
           chatId: config.chatId,
@@ -251,13 +246,11 @@ export async function sendViaTelegram(
   // tapped prompt is deleted immediately by the webhook callback handler;
   // this row is the fallback and is harmless once the message is gone.
   if (result.ok && result.messageId && interactiveKeyboard) {
-    await scheduleTelegramAutoDelete(payload.userId, config.chatId, [
-      result.messageId,
-    ]);
+    await scheduleTelegramAutoDelete(userId, config.chatId, [result.messageId]);
   }
 
   if (result.ok) {
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "TELEGRAM",
       eventType: payload.eventType,
@@ -266,7 +259,7 @@ export async function sendViaTelegram(
     return { ok: true, messageId: result.messageId };
   }
   const classified = classifyTelegramError(result.errorDescription);
-  recordPushAttempt({
+  recordPushAttemptForPayload(payload, userId, {
     userId: payload.userId,
     channel: "TELEGRAM",
     eventType: payload.eventType,
diff --git a/src/lib/notifications/senders/web-push.ts b/src/lib/notifications/senders/web-push.ts
index 84b6a25fa..f0e080dac 100644
--- a/src/lib/notifications/senders/web-push.ts
+++ b/src/lib/notifications/senders/web-push.ts
@@ -5,7 +5,7 @@ import type { SendOutcome } from "@/lib/notifications/retry-policy";
 import { classifyHttpStatus } from "@/lib/notifications/retry-policy";
 import { getVapidConfig } from "@/lib/notifications/vapid-config";
 import { getEvent } from "@/lib/logging/context";
-import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { isPublicUrl } from "@/lib/validations/notifications";
 import { safeFetch } from "@/lib/safe-fetch";
 import { plainPushText } from "@/lib/notifications/strip-emoji";
@@ -36,7 +36,7 @@ export async function sendViaWebPush(
     const config = await getVapidConfig();
     if (!config) {
       getEvent()?.addWarning("Web Push: VAPID keys not configured");
-      recordPushAttempt({
+      recordPushAttemptForPayload(payload, userId, {
         userId,
         channel: "WEB_PUSH",
         eventType: payload.eventType,
@@ -65,7 +65,7 @@ export async function sendViaWebPush(
       // may simply not have hit "Subscribe" on this browser. Counting
       // this as a give-up signal would lock the user out of the channel
       // they just configured. Treat it as a soft "no recipient" instead.
-      recordPushAttempt({
+      recordPushAttemptForPayload(payload, userId, {
         userId,
         channel: "WEB_PUSH",
         eventType: payload.eventType,
@@ -231,7 +231,7 @@ export async function sendViaWebPush(
     }
 
     if (anySuccess) {
-      recordPushAttempt({
+      recordPushAttemptForPayload(payload, userId, {
         userId,
         channel: "WEB_PUSH",
         eventType: payload.eventType,
@@ -243,7 +243,7 @@ export async function sendViaWebPush(
     // Every sub returned a permanent 410/404 → channel is dead until
     // the user re-pairs a device. This is a hard reject.
     if (allPermanentReject && expiredIds.length === subscriptions.length) {
-      recordPushAttempt({
+      recordPushAttemptForPayload(payload, userId, {
         userId,
         channel: "WEB_PUSH",
         eventType: payload.eventType,
@@ -260,7 +260,7 @@ export async function sendViaWebPush(
 
     // Soft failure (5xx / 429 / fetch error) on at least one sub.
     const classified = classifyHttpStatus(lastTransientStatus, "web-push");
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId,
       channel: "WEB_PUSH",
       eventType: payload.eventType,
@@ -279,7 +279,7 @@ export async function sendViaWebPush(
         ? err
         : new Error("[web-push] sendViaWebPush failed"),
     );
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId,
       channel: "WEB_PUSH",
       eventType: payload.eventType,
diff --git a/src/lib/notifications/senders/webhook.ts b/src/lib/notifications/senders/webhook.ts
index e7a890aee..fd01eeac8 100644
--- a/src/lib/notifications/senders/webhook.ts
+++ b/src/lib/notifications/senders/webhook.ts
@@ -5,7 +5,7 @@ import type {
 import type { SendOutcome } from "@/lib/notifications/retry-policy";
 import { classifyHttpStatus } from "@/lib/notifications/retry-policy";
 import { getEvent } from "@/lib/logging/context";
-import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+import { recordPushAttemptForPayload } from "@/lib/notifications/senders/push-attempt-record";
 import { safeFetch } from "@/lib/safe-fetch";
 import { plainPushText } from "@/lib/notifications/strip-emoji";
 
@@ -32,6 +32,7 @@ export async function sendViaWebhook(
   config: WebhookChannelConfig,
   payload: NotificationPayload,
 ): Promise<SendOutcome> {
+  const userId = payload.recipientUserId ?? payload.userId;
   const start = performance.now();
   try {
     const headers: Record<string, string> = {
@@ -82,7 +83,7 @@ export async function sendViaWebhook(
     });
 
     if (res.ok) {
-      recordPushAttempt({
+      recordPushAttemptForPayload(payload, userId, {
         userId: payload.userId,
         channel: "WEBHOOK",
         eventType: payload.eventType,
@@ -91,7 +92,7 @@ export async function sendViaWebhook(
       return { ok: true, statusCode: res.status };
     }
     const classified = classifyHttpStatus(res.status, "webhook");
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "WEBHOOK",
       eventType: payload.eventType,
@@ -112,7 +113,7 @@ export async function sendViaWebhook(
       duration_ms: Math.round(performance.now() - start),
       error: message,
     });
-    recordPushAttempt({
+    recordPushAttemptForPayload(payload, userId, {
       userId: payload.userId,
       channel: "WEBHOOK",
       eventType: payload.eventType,
diff --git a/src/lib/notifications/types.ts b/src/lib/notifications/types.ts
index 25b494515..7b7d7bbd8 100644
--- a/src/lib/notifications/types.ts
+++ b/src/lib/notifications/types.ts
@@ -252,7 +252,15 @@ export interface EmailChannelConfig {
 
 export interface NotificationPayload {
   eventType: EventType;
+  /**
+   * Health-record subject retained for established self-delivery callers.
+   * Managed delivery must also declare `recordUserId` and `recipientUserId`.
+   */
   userId: string;
+  /** The health record that supplies notification content and calculations. */
+  recordUserId?: string;
+  /** The account whose channel, locale, and preferences receive the delivery. */
+  recipientUserId?: string;
   title: string;
   message: string;
   /** Channel-specific extras (e.g. medicationId for Telegram inline buttons) */
diff --git a/src/lib/telegram-webhook-handlers.ts b/src/lib/telegram-webhook-handlers.ts
index 6bd22fec3..7bd4568e2 100644
--- a/src/lib/telegram-webhook-handlers.ts
+++ b/src/lib/telegram-webhook-handlers.ts
@@ -90,10 +90,17 @@ function resolveBotLocale(value: string | null | undefined): Locale {
   return "de";
 }
 
-async function cleanupReminderTracking(medicationId: string): Promise<void> {
+async function cleanupReminderTracking(
+  recipientUserId: string,
+  medicationId: string,
+): Promise<void> {
   try {
     await prisma.telegramReminderMessage.deleteMany({
-      where: { medicationId },
+      where: {
+        recipientUserId,
+        medicationId,
+        medication: { userId: recipientUserId },
+      },
     });
   } catch {
     // Best-effort cleanup
@@ -153,6 +160,7 @@ async function resolveReminderSlot(input: {
 }): Promise<Date | null> {
   const reminder = await prisma.telegramReminderMessage.findFirst({
     where: {
+      recipientUserId: input.userId,
       medicationId: input.medicationId,
       chatId: input.chatId,
       messageId: input.messageId,
@@ -398,7 +406,7 @@ export async function handleCallback(update: TelegramUpdate) {
     if (messageId) {
       await deleteMessage(botToken, chatId, messageId);
     }
-    await cleanupReminderTracking(medicationId);
+    await cleanupReminderTracking(user.id, medicationId);
   } else if (data.startsWith("snooze:")) {
     // Format: "snooze:{medicationId}:{minutes}"
     const parts = data.split(":");
@@ -443,7 +451,7 @@ export async function handleCallback(update: TelegramUpdate) {
     if (messageId) {
       await deleteMessage(botToken, chatId, messageId);
     }
-    await cleanupReminderTracking(medicationId);
+    await cleanupReminderTracking(user.id, medicationId);
   } else if (data.startsWith("skip:")) {
     const medicationId = data.slice("skip:".length).trim();
     if (!medicationId) {
@@ -586,7 +594,7 @@ export async function handleCallback(update: TelegramUpdate) {
     if (messageId) {
       await deleteMessage(botToken, chatId, messageId);
     }
-    await cleanupReminderTracking(medicationId);
+    await cleanupReminderTracking(user.id, medicationId);
   } else if (data.startsWith("ack:")) {
     const medicationId = data.slice("ack:".length).trim();
     if (!medicationId) {
@@ -613,7 +621,7 @@ export async function handleCallback(update: TelegramUpdate) {
     if (messageId) {
       await deleteMessage(botToken, chatId, messageId);
     }
-    await cleanupReminderTracking(medicationId);
+    await cleanupReminderTracking(user.id, medicationId);
   } else if (data.startsWith("add:")) {
     // Format: "add:{medicationId}" or "add:{medicationId}:umid:{userMsgId}"
     const withoutPrefix = data.slice("add:".length);
diff --git a/tests/integration/notification-attribution.test.ts b/tests/integration/notification-attribution.test.ts
new file mode 100644
index 000000000..7f9e411b5
--- /dev/null
+++ b/tests/integration/notification-attribution.test.ts
@@ -0,0 +1,526 @@
+import { beforeEach, describe, expect, it, vi } from "vitest";
+
+import { getPrismaClient, truncateAllTables } from "./setup";
+import { resolveNotificationDeliveryIdentity } from "@/lib/notifications/delivery-identity";
+import {
+  claimNotificationEvent,
+} from "@/lib/notifications/reminder-dedup";
+import { recordPushAttempt } from "@/lib/notifications/senders/push-attempt-record";
+
+let sequence = 0;
+
+async function createUser(label: string, managed = false) {
+  const suffix = sequence++;
+  return getPrismaClient().user.create({
+    data: {
+      username: `${label}-${suffix}`,
+      email: `${label}-${suffix}@example.test`,
+      managedProfileAt: managed ? new Date() : null,
+    },
+  });
+}
+
+async function createGuardianGrant(input: {
+  recordUserId: string;
+  recipientUserId: string;
+  access?: "READ" | "WRITE" | "MANAGE";
+  acceptedAt?: Date | null;
+  revokedAt?: Date | null;
+  expiresAt?: Date | null;
+}) {
+  return getPrismaClient().accountGrant.create({
+    data: {
+      grantorId: input.recordUserId,
+      granteeId: input.recipientUserId,
+      access: input.access ?? "MANAGE",
+      acceptedAt:
+        input.acceptedAt === undefined ? new Date() : input.acceptedAt,
+      revokedAt: input.revokedAt ?? null,
+      revokedBy: input.revokedAt ? "GRANTOR" : null,
+      expiresAt: input.expiresAt ?? null,
+    },
+  });
+}
+
+beforeEach(async () => {
+  await truncateAllTables(getPrismaClient());
+});
+
+describe("notification attribution (real Postgres)", () => {
+  it("persistence retains distinct record and recipient principals", async () => {
+    const recordUser = await createUser("record", true);
+    const recipientUser = await createUser("recipient");
+
+    recordPushAttempt({
+      recordUserId: recordUser.id,
+      recipientUserId: recipientUser.id,
+      channel: "NTFY",
+      eventType: "MEDICATION_REMINDER",
+      result: "ok",
+    });
+
+    await vi.waitFor(async () => {
+      const attempt = await getPrismaClient().pushAttempt.findFirstOrThrow({
+        where: {
+          recordUserId: recordUser.id,
+          recipientUserId: recipientUser.id,
+        },
+        select: {
+          recordUserId: true,
+          recipientUserId: true,
+          channel: true,
+          eventType: true,
+        },
+      });
+
+      expect(attempt).toEqual({
+        recordUserId: recordUser.id,
+        recipientUserId: recipientUser.id,
+        channel: "NTFY",
+        eventType: "MEDICATION_REMINDER",
+      });
+    });
+  });
+
+  it("persistence leaves explicit self attribution unchanged", async () => {
+    const self = await createUser("self");
+
+    const attempt = await getPrismaClient().pushAttempt.create({
+      data: {
+        userId: self.id,
+        recordUserId: self.id,
+        recipientUserId: self.id,
+        channel: "NTFY",
+        eventType: "MEDICATION_REMINDER",
+        result: "ok",
+      },
+      select: {
+        userId: true,
+        recordUserId: true,
+        recipientUserId: true,
+      },
+    });
+
+    expect(attempt).toEqual({
+      userId: self.id,
+      recordUserId: self.id,
+      recipientUserId: self.id,
+    });
+  });
+
+  it("persists a managed reminder anchor as a record event without a delivery attempt", async () => {
+    const recordUser = await createUser("managed-record", true);
+    const client = getPrismaClient();
+    const now = new Date();
+
+    await expect(
+      claimNotificationEvent(client, {
+        recordUserId: recordUser.id,
+        eventType: "MEDICATION_REMINDER",
+        dedupKey: "med:slot",
+        since: new Date(now.getTime() - 48 * 60 * 60 * 1000),
+      }),
+    ).resolves.toBe(true);
+    await expect(
+      claimNotificationEvent(client, {
+        recordUserId: recordUser.id,
+        eventType: "MEDICATION_REMINDER",
+        dedupKey: "med:slot",
+        since: new Date(now.getTime() - 48 * 60 * 60 * 1000),
+      }),
+    ).resolves.toBe(false);
+
+    const event = await client.notificationEvent.findFirstOrThrow({
+      where: { recordUserId: recordUser.id, dedupKey: "med:slot" },
+      select: { id: true },
+    });
+    expect(await client.pushAttempt.count()).toBe(0);
+    await client.user.delete({ where: { id: recordUser.id } });
+    expect(
+      await client.notificationEvent.findUnique({ where: { id: event.id } }),
+    ).toBeNull();
+  });
+
+  it("allows exactly one concurrent claim for a notification event", async () => {
+    const recordUser = await createUser("claim-record", true);
+    const client = getPrismaClient();
+    const since = new Date(Date.now() - 60_000);
+    const input = {
+      recordUserId: recordUser.id,
+      eventType: "MEDICATION_REMINDER",
+      dedupKey: "med:race",
+      since,
+    };
+
+    const results = await Promise.all([
+      claimNotificationEvent(client, input),
+      claimNotificationEvent(client, input),
+    ]);
+
+    expect(results.filter(Boolean)).toHaveLength(1);
+    expect(
+      await client.notificationEvent.count({
+        where: {
+          recordUserId: recordUser.id,
+          eventType: "MEDICATION_REMINDER",
+          dedupKey: "med:race",
+        },
+      }),
+    ).toBe(1);
+  });
+
+  it("uses the rolling window and allows a retry after a failed claim", async () => {
+    const client = getPrismaClient();
+    const missingRecordId = `missing-claim-${sequence++}`;
+    const missingInput = {
+      recordUserId: missingRecordId,
+      eventType: "SYSTEM_ALERT",
+      dedupKey: "safety:retry",
+      since: new Date(Date.now() - 24 * 60 * 60 * 1000),
+    };
+
+    await expect(claimNotificationEvent(client, missingInput)).resolves.toBe(
+      false,
+    );
+    await client.user.create({
+      data: {
+        id: missingRecordId,
+        username: `claim-retry-${sequence++}`,
+        email: `claim-retry-${sequence++}@example.test`,
+      },
+    });
+    await expect(claimNotificationEvent(client, missingInput)).resolves.toBe(
+      true,
+    );
+
+    const recordUser = await createUser("expired-claim", true);
+    const now = new Date();
+    await client.notificationEvent.create({
+      data: {
+        recordUserId: recordUser.id,
+        eventType: "SYSTEM_ALERT",
+        dedupKey: "safety:window",
+        createdAt: new Date(now.getTime() - 25 * 60 * 60 * 1000),
+      },
+    });
+
+    await expect(
+      claimNotificationEvent(client, {
+        recordUserId: recordUser.id,
+        eventType: "SYSTEM_ALERT",
+        dedupKey: "safety:window",
+        since: new Date(now.getTime() - 24 * 60 * 60 * 1000),
+      }),
+    ).resolves.toBe(true);
+  });
+
+  it("keeps Telegram reminder tracking independent for each recipient slot", async () => {
+    const recordUser = await createUser("telegram-record", true);
+    const firstRecipient = await createUser("telegram-recipient-a");
+    const secondRecipient = await createUser("telegram-recipient-b");
+    const client = getPrismaClient();
+    const medication = await client.medication.create({
+      data: {
+        userId: recordUser.id,
+        name: "Tracking medication",
+        dose: "1 tablet",
+        schedules: {
+          create: { windowStart: "08:00", windowEnd: "08:00" },
+        },
+      },
+      include: { schedules: true },
+    });
+    const scheduleId = medication.schedules[0]!.id;
+    const slot = {
+      medicationId: medication.id,
+      scheduleId,
+      date: "2026-08-06",
+      phase: "YELLOW" as const,
+      timeOfDay: "08:00",
+    };
+
+    await client.telegramReminderMessage.createMany({
+      data: [
+        {
+          recipientUserId: firstRecipient.id,
+          ...slot,
+          chatId: "first-chat",
+          messageId: 101,
+        },
+        {
+          recipientUserId: secondRecipient.id,
+          ...slot,
+          chatId: "second-chat",
+          messageId: 202,
+        },
+      ],
+    });
+
+    await client.telegramReminderMessage.upsert({
+      where: {
+        recipientUserId_medicationId_scheduleId_date_phase_timeOfDay: {
+          recipientUserId: firstRecipient.id,
+          ...slot,
+        },
+      },
+      create: {
+        recipientUserId: firstRecipient.id,
+        ...slot,
+        chatId: "unused-create-chat",
+        messageId: 303,
+      },
+      update: { chatId: "first-chat-new", messageId: 303 },
+    });
+
+    expect(
+      await client.telegramReminderMessage.findMany({
+        where: { medicationId: medication.id },
+        orderBy: { recipientUserId: "asc" },
+        select: { recipientUserId: true, chatId: true, messageId: true },
+      }),
+    ).toEqual([
+      {
+        recipientUserId: firstRecipient.id,
+        chatId: "first-chat-new",
+        messageId: 303,
+      },
+      {
+        recipientUserId: secondRecipient.id,
+        chatId: "second-chat",
+        messageId: 202,
+      },
+    ]);
+
+    await client.user.delete({ where: { id: firstRecipient.id } });
+    expect(
+      await client.telegramReminderMessage.count({
+        where: { medicationId: medication.id },
+      }),
+    ).toBe(1);
+  });
+
+  it("persistence maps an omitted pair from the legacy recipient", async () => {
+    const self = await createUser("legacy");
+
+    const attempt = await getPrismaClient().pushAttempt.create({
+      data: {
+        userId: self.id,
+        channel: "NTFY",
+        eventType: "MEDICATION_REMINDER",
+        result: "ok",
+      },
+      select: {
+        recordUserId: true,
+        recipientUserId: true,
+      },
+    });
+
+    expect(attempt).toEqual({
+      recordUserId: self.id,
+      recipientUserId: self.id,
+    });
+  });
+
+  it("persistence rejects a partial or contradictory principal pair atomically", async () => {
+    const recordUser = await createUser("record", true);
+    const recipientUser = await createUser("recipient");
+    const otherUser = await createUser("other");
+
+    await expect(
+      getPrismaClient().pushAttempt.create({
+        data: {
+          userId: recipientUser.id,
+          recordUserId: recordUser.id,
+          channel: "NTFY",
+          eventType: "MEDICATION_REMINDER",
+          result: "ok",
+        },
+      }),
+    ).rejects.toThrow("push attempt attribution requires both principals");
+
+    await expect(
+      getPrismaClient().pushAttempt.create({
+        data: {
+          userId: otherUser.id,
+          recordUserId: recordUser.id,
+          recipientUserId: recipientUser.id,
+          channel: "NTFY",
+          eventType: "MEDICATION_REMINDER",
+          result: "ok",
+        },
+      }),
+    ).rejects.toThrow("push attempt recipient must match user_id");
+
+    expect(await getPrismaClient().pushAttempt.count()).toBe(0);
+  });
+
+  it("persistence refuses a managed recipient and cascades an attributed recipient deletion", async () => {
+    const recordUser = await createUser("record", true);
+    const recipientUser = await createUser("recipient");
+    const managedRecipient = await createUser("managed-recipient", true);
+
+    await expect(
+      getPrismaClient().pushAttempt.create({
+        data: {
+          userId: managedRecipient.id,
+          recordUserId: recordUser.id,
+          recipientUserId: managedRecipient.id,
+          channel: "NTFY",
+          eventType: "MEDICATION_REMINDER",
+          result: "ok",
+        },
+      }),
+    ).rejects.toThrow("managed profile cannot receive notification delivery");
+
+    const attempt = await getPrismaClient().pushAttempt.create({
+      data: {
+        userId: recipientUser.id,
+        recordUserId: recordUser.id,
+        recipientUserId: recipientUser.id,
+        channel: "NTFY",
+        eventType: "MEDICATION_REMINDER",
+        result: "ok",
+      },
+    });
+    await getPrismaClient().user.delete({ where: { id: recipientUser.id } });
+
+    expect(
+      await getPrismaClient().pushAttempt.findUnique({
+        where: { id: attempt.id },
+      }),
+    ).toBeNull();
+  });
+
+  it("principal resolution requires an active MANAGE grant for managed delivery", async () => {
+    const recordUser = await createUser("record", true);
+    const recipientUser = await createUser("recipient");
+    const ordinaryRecord = await createUser("ordinary");
+
+    await expect(
+      resolveNotificationDeliveryIdentity({
+        eventType: "MEDICATION_REMINDER",
+        userId: recordUser.id,
+        recordUserId: recordUser.id,
+        recipientUserId: recipientUser.id,
+        title: "Record content",
+        message: "Record schedule",
+      }),
+    ).resolves.toBeNull();
+
+    await createGuardianGrant({
+      recordUserId: recordUser.id,
+      recipientUserId: recipientUser.id,
+    });
+
+    await expect(
+      resolveNotificationDeliveryIdentity({
+        eventType: "MEDICATION_REMINDER",
+        userId: recordUser.id,
+        recordUserId: recordUser.id,
+        recipientUserId: recipientUser.id,
+        title: "Record content",
+        message: "Record schedule",
+      }),
+    ).resolves.toEqual({
+      recordUserId: recordUser.id,
+      recipientUserId: recipientUser.id,
+      managed: true,
+    });
+
+    await expect(
+      resolveNotificationDeliveryIdentity({
+        eventType: "MEDICATION_REMINDER",
+        userId: recordUser.id,
+        title: "Record content",
+        message: "Record schedule",
+      }),
+    ).resolves.toBeNull();
+
+    await expect(
+      resolveNotificationDeliveryIdentity({
+        eventType: "MEDICATION_REMINDER",
+        userId: ordinaryRecord.id,
+        recordUserId: ordinaryRecord.id,
+        recipientUserId: recipientUser.id,
+        title: "Record content",
+        message: "Record schedule",
+      }),
+    ).resolves.toBeNull();
+  });
+
+  it("principal resolution rejects inactive, insufficient, wrong-record, and managed-recipient grants", async () => {
+    const recordUser = await createUser("record", true);
+    const otherRecord = await createUser("other-record", true);
+    const pendingRecipient = await createUser("pending-recipient");
+    const revokedRecipient = await createUser("revoked-recipient");
+    const expiredRecipient = await createUser("expired-recipient");
+    const writeRecipient = await createUser("write-recipient");
+    const wrongRecordRecipient = await createUser("wrong-record-recipient");
+    const managedRecipient = await createUser("managed-recipient", true);
+
+    await Promise.all([
+      createGuardianGrant({
+        recordUserId: recordUser.id,
+        recipientUserId: pendingRecipient.id,
+        acceptedAt: null,
+      }),
+      createGuardianGrant({
+        recordUserId: recordUser.id,
+        recipientUserId: revokedRecipient.id,
+        revokedAt: new Date(),
+      }),
+      createGuardianGrant({
+        recordUserId: recordUser.id,
+        recipientUserId: expiredRecipient.id,
+        expiresAt: new Date(Date.now() - 1_000),
+      }),
+      createGuardianGrant({
+        recordUserId: recordUser.id,
+        recipientUserId: writeRecipient.id,
+        access: "WRITE",
+      }),
+      createGuardianGrant({
+        recordUserId: otherRecord.id,
+        recipientUserId: wrongRecordRecipient.id,
+      }),
+      createGuardianGrant({
+        recordUserId: recordUser.id,
+        recipientUserId: managedRecipient.id,
+      }),
+    ]);
+
+    for (const recipientUserId of [
+      pendingRecipient.id,
+      revokedRecipient.id,
+      expiredRecipient.id,
+      writeRecipient.id,
+      wrongRecordRecipient.id,
+      managedRecipient.id,
+    ]) {
+      await expect(
+        resolveNotificationDeliveryIdentity({
+          eventType: "MEDICATION_REMINDER",
+          userId: recordUser.id,
+          recordUserId: recordUser.id,
+          recipientUserId,
+          title: "Record content",
+          message: "Record schedule",
+        }),
+      ).resolves.toBeNull();
+    }
+
+    const ordinaryUser = await createUser("ordinary-self");
+    await expect(
+      resolveNotificationDeliveryIdentity({
+        eventType: "MEDICATION_REMINDER",
+        userId: ordinaryUser.id,
+        title: "Personal content",
+        message: "Personal schedule",
+      }),
+    ).resolves.toEqual({
+      recordUserId: ordinaryUser.id,
+      recipientUserId: ordinaryUser.id,
+      managed: false,
+    });
+  });
+});