Thank you for submitting the form.
**If you selected in your treatment agreement form that you would like us submit claims for payment to your health insurance policies on your behalf, YOU'RE ALMOST DONE. Your NEXT STEP is to send us a copy of the front and back of your insurance ID card(s) (both primary and secondary insurances, if applicable.). You can do this through HIPPA-compliant secure end-to-end encrypted email firstname.lastname@example.org or by FAX 253-212-3225.**
Admin@dialogicaltherapy.com hosted by Hushforms has received your completed form. Hushmail is a secure email service which Dialogical Therapy, PLLC uses to receive webforms via secure email. Secure email enforces the use of multiple layers of encryption, which is a method of scrambling information so that it cannot be read by anyone other than the intended recipient.
If you have any questions, feel free to contact us.