In order for Sahaya Therapy, LLC to accept and bill your credit card, please complete all fields in its entirety, sign, date and click on submit. All information submitted is strictly confidential and Sahaya Therapy, LLC adheres to the highest standards of account data protection.
As it appears on your credit card statement.
Complete the Pre-registration information, HIPAA and Consent Forms, payment information, Insurance card JPG image, EAP authorization and all other demographic information before scheduling your first session.
