Confidential · HIPAA-Secured

Verify Your Insurance & Start Your Intake

Tell us a little about you and upload your insurance card. Our team verifies coverage and reaches out — usually within an hour.

~5 minutes

HIPAA-secured

No commitment

Your Information

The basics we need to identify your file.

First Name *

Last Name *

Date of Birth *

Phone Number *

Email Address *

Found right on your insurance card.

Insurance Company *

Member ID / Policy Number *

A clear photo of your insurance card and ID helps us verify benefits faster.

Front of insurance card * JPG, PNG, HEIC, or PDF · up to 10 MB

Choose a file or drag & drop here

Back of insurance card Optional Helpful but not required

Choose a file or drag & drop here

Driver's license or photo ID * Required for identity verification

Choose a file or drag & drop here

Anything else you think we'd find helpful — completely optional.

Other helpful documents Optional You can select multiple files

Choose files or drag & drop here

Tell us anything you'd like our admissions team to know.

Your information is encrypted end-to-end and only seen by our admissions team. Protected by HIPAA.

No cost to verify, no obligation to enroll

Your privacy is always our priority

Someone is always here to help

Compassionate, confidential support