Verify Your Insurance Coverage

At Safe Harbor Recovery Center, we are committed to making recovery as affordable as possible. We accept most insurance plans, and we offer a secure online verification form for your convenience.

Please fill out the form below as completely as possible, and we will be in touch with you shortly.

"*" indicates required fields

Patient Name:*

First Last

Patient Phone Number:*

Point of Contact (who should we call back if NOT Patient Name above) :

Point of Contact Phone Number:

Patient Date Of Birth:*

Email Address:*

Primary Insured Address:*

Street Address Address Line 2 City State ZIP Code

Primary Insured Name:*

Primary Insured Phone Number:*

Primary Insured Date Of Birth:*

Insurance Company Name:*

Insurance Company Phone Number for Providers (Mental Health or Substance Abuse):*

ID #:*

Group #:*

Will the patient be getting FMLA Leave while in treatment?*

FMLA refers to the Family and Medical Leave Act, which is a federal law that guarantees certain employees up to 12 workweeks of unpaid leave each year with no threat of job loss. FMLA also requires that employers covered by the law maintain the health benefits for eligible workers just as if they were working.

How did you hear about us?*

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Contact Us to Learn More

If you’re researching treatment options for yourself or a loved one, we’re happy to answer any questions you may have or schedule a tour of the Safe Harbor Recovery Center facility. Call today to speak with one of our admissions representatives.

Call (888) 932-2304