How do you plan to cover services?
If you have coverage under more than one insurance plan, we will need information about all plans. If we don't have coverage information for all active plans, this can result in denied claims, a pause in services, or additional charges. If you have dual coverage through a non-Medicaid and a Medicaid (Apple Health) plan, please list the non-Medicaid plan as your primary.
Upload a photo of your insurance card
(If not self)
(If applicable)
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For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.