Insurance Verification Form


To expedite the insurance verification process, please fill out the insurance verification form below. Fill in all fields to the best of your abilities. Add any additional information in the “Comments” section, then click Submit.

Shortly after you’ve submitted your insurance verification form, one of our Admissions Counselors will call you to further discuss your needs and current situation so that we can determine the best course of action. We will usually be able to verify your benefits within a few hours.

Once the insurance is verified and you are an appropriate fit at Liberty Welless, we feel we can admit you quickly to our outpatient drug rehab center.

get confidential help now:

833-542-9355

 OR SCHEDULE A FREE, CONFIDENTIAL EVALUATION AT OUR PROGRAM

get help immediately:

833-542-9355

 OR FILL OUT THE FORM BELOW

Confidential Contact Form

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