Verify Your Insurance

Verify Your Insurance

Looking for treatment, but not quite sure what your insurance will cover? Fill out the form to the right with your information and we will find treatment options that are covered completely. All information you submit is kept entirely confidential, being used solely to verify benefits for treatment.

Your Name (required)

Your Email (required)

Insurance Company

Policy Number

Group Number

Provider Phone Number

Primary Policy Holder

Primary Policy Holder Date of Birth

Your Date of Birth

Home Address (to verify benefits)