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Insurance Verification Form

Because insurance covers everyone differently, we request that an insurance verification form be completed prior to the day of your therapy evaluation .  This form allows us to notify you of your coverage and inform you of any copays or fees.  Click Here to obtain the insurance verification form.



We can collect this information from you over the phone , or you can complete the form and return it to us before you begin your therapy.


For ease of access we have the form available on this web page, or you can obtain it from either of our two outpatient locations (see our Services page for location information). 



You can return the form to us via:

Fax: (610) 438-2024

Mail: 2222 Sullivan Trail #105 Easton, PA 18040



Hand delivery at one of the two outpatient sites.

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