Please fill out this form as required to utilize your insurance for your sessions. Once we receive this form, we will verify your information with your insurance company as soon as possible. Please allow us time to do so, as we are busy throughout the day. Once we have verified your information, find out if you have a copay, how much your copay may be, and if there is a visit limit, we will notify you via email or phone.

***Please let us know if you have any issues with the form! We can resend it or you can send us your information via email.