⚠️ Important Notice: Please do not submit any Protected Health Information (PHI) through this form. This form is intended for general inquiries and scheduling only.

By checking this box, I acknowledge and agree to the following:

• I understand that this form is intended for general inquiries and scheduling only.

• I agree not to submit any Protected Health Information (PHI) through this form.

• I understand that electronic communication (including this form) may not be fully secure and confidential.

I consent to being contacted by Sanara Mental Health via the information I have provided for the purpose of scheduling or responding to my inquiry.