Insurance

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Enter your EAP Name & Authorization number here. If you don't have it, please bring it to your first session.
  • Drop files here or
    Accepted file types: jpeg, jpg, gif, png, pdf, Max. file size: 256 MB, Max. files: 2.
      Please upload the front and back of your insurance card
    • MM slash DD slash YYYY
    • Drop files here or
      Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB, Max. files: 2.
        Please upload the front and back of your insurance card
      • MM slash DD slash YYYY
      • MM slash DD slash YYYY