Insurance Verification Form

Clients who wish to bill therapy sessions through their insurance must complete this verification form prior to their first Three Oaks appointment. Please visit our [FAQ page] to learn more!

For insurance related questions, please email LaShawn, our Billing Team member:
verifications@threeoaksbehavioralhealth.com

Please choose one of the following.
Must match the name listed with insurance.
We recognize and honor that many of our clients identify by names other than their current legal name and know, express, and/or identify their gender in a non-binary way.
Must match the sex listed with insurance. (Gender selection for insurance claim forms only includes male or female, binary options.)
What is the name of your Three Oaks therapist? If you have not yet been connected with a therapist on our team, please first submit a contact form. We look forward to welcoming you to the practice!
How will you be meeting with your therapist?
Please select all that apply.

Documents Needed to Complete Verification

Before uploading an additional document, please verify that the document's name and file size appear in the box.
Click or drag a file to this area to upload.
Please upload a photo of your government issued ID (for example, driver’s license or passport).
Click or drag a file to this area to upload.
Please upload a photo of the FRONT of your insurance card.
Click or drag a file to this area to upload.
Please upload a photo of the BACK of your insurance card.