AT SEAGLASS

IN PRESCOTT, ARIZONA

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Verify My Insurance

Contact Royal Life Centers at Seaglass by calling or filling out our insurance verification form below.

Taking the first step towards change is the biggest challenge, but the results are more than rewarding. Contact us today, and our experienced admissions coordinators will make the process of getting help easy.

Below is our insurance verification form. With so many insurance providers and policies, this form will make verifying your insurance benefits much easier. Once you fill out this form and submit it, our admissions coordinators will be able to check your individual policy to see what your specific insurance coverage looks like. Alternatively, you can always call us directly in order for us to verify your insurance.

Verify Your Insurance

Please fill out this secure form and one of our admissions professionals will contact you shortly.

"*" indicates required fields

Name*

First Last

Phone*

Email*

Date of Birth*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Insurance Company*

Plan Type(HMO,PPO)*

Name on Card*

Member ID*

Insurance Phone*

Group ID*

Social Security #*

Alcohol Consumption?*

Drug Use?(Please List)*

Health Issues?*

Phone

This field is for validation purposes and should be left unchanged.

Would you like to discuss treatment over the phone?

Our 24/7 admissions department will gladly guide you through the insurance verification process!

Royal Life Centers at Seaglass works with most major insurances

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707 W Gurley St, Prescott, AZ 86305

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