Admissions Insurance Verification Form
NOTE: All the following information is required so we can provide you with an accurate assessment. All information is securely transmitted and our email system is HIPPA compliant to ensure the security of your information.
We are a licensed residential holistic mental health and addiction treatment center, that has helped 1000's of men and women withdrawal from drug addictions over the past 11 years. We care about you and your health. By filling out this form you are asking us to check your Insurance Provider Benefits and contact you back about your insurance coverages and any other options that are available to you for treatment services.