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I agree to terms & conditions, and privacy policy by the practice. By providing my email and phone number, I consent to receive SMS notifications, alerts and occasional marketing communication from Marlin Sandlin Therapy. Message frequency varies. Message & data rates may apply. By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold us harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.