Insurance Verification

We believe that treatment should be accessible and affordable. That’s why we accept most major insurances, including private insurance, PPO, and out-of-network plans. Verify your insurance below to get started.

Verify Your Insurance

Patient Name*(Required)

Last

Patient Date of Birth*(Required)

Patient Phone Number*(Required)

Primary Insured Name*(Required)

Last

Primary Insured Date of Birth*(Required)

Primary Insured Address*(Required)

City(Required)

State(Required)

Ziip(Required)

Insurance Company Name*(Required)

Insurance Company Phone Number*(Required)

ID #*(Required)

Group ID #*(Required)

Person Filling Out This Form Or Point of Contact (who should we call back if NOT Patient Name above):

Your Name*(Required)

Last Name(Required)

Your Phone*(Required)

Your Email*(Required)

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Name

This field is for validation purposes and should be left unchanged.

Insurance Verification

Verify Your Insurance

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