Insurance Verification

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Your Contact Information
Your Name*
First Last
Return Callback Phone Number*
Email*
Who is seeking treatment?*
- Yourself
- A Loved One
How Did You Hear About Us?
Loved Ones Information
Your Information
Loved Ones Name*
First Last
Loved Ones Date Of Birth*
MM slash DD slash YYYY
Your Date Of Birth*
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Additional Information
Insurance Information
Would you like us to verify your or a loved ones insurance benefits?*
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Policy Holders Name*
First Last
Policy Holders Date Of Birth*
MM slash DD slash YYYY
Policy Holders Address**
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Insurance Company's Name*
Insurance Company's Phone Number*
Member ID*
Group Number*
Subscriber relationship to client*
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TOGETHER, WE CAN RECOVER

Where Addiction Ends
and Recovery Begins

Our addiction specialists are always ready to answer your questions and help you access the care you need. Every patient in our care receives a personalized treatment plan that takes into account their unique needs.

Insurance Verification

Start Your Recovery Today

Start Your Recovery Today

Your Contact Information

Loved Ones Information

Your Information

Insurance Information

Where Addiction Ends and Recovery Begins

TruHealing Centers

TOGETHER, WE CAN RECOVER

Where Addiction Ends and Recovery Begins

Where Addiction Ends
and Recovery Begins

Where Addiction Ends
and Recovery Begins