We Value Your Privacy

All treatment inquiries and personal information is always kept confidential.


We are always here to help

Our admissions team is available 24/7 to answer your questions. Call anytime.


We are not a referral service

You are speaking with an admissions specialist who is at The Ohana. No call centers or agencies.

Confidential Insurance Benefits Verification Form


Please fill-out this brief information form in case we need to contact you about your insurance information below. Rest assured that all information shared with us is confidential.

DOB*

Are you the Primary Policy Holder for this insurance policy?
Briefly describe what substances you're struggling with and if you've ever been in treatment before. You can also use this area to add any additional information/questions that you may have for our team.
After pressing the submit button below, please wait up to one minute for your insurance data to be securely transmitted.
Submit