Verify Your Insurance Coverage

At Wooded Glen, we want you to get the help you need. That’s why we accept most major insurance plans, and offer competitive self-pay rates, to provide affordable addiction treatment in Indiana.

Please fill out the form below as completely as possible, and we will be in touch with you shortly.

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Patient Name:*

First Last

Patient Phone Number:*

Point of Contact (who should we call back if NOT Patient Name above) :

Point of Contact Phone Number:

Patient Date Of Birth:*

Email Address:*

Primary Insured Address:*

Street Address Address Line 2 City State ZIP Code

Primary Insured Name:*

Primary Insured Phone Number:*

Primary Insured Date Of Birth:*

Insurance Company Name:*

Insurance Company Phone Number for Providers (Mental Health or Substance Abuse):*

ID #:*

Group #:*

Will the patient be getting FMLA Leave while in treatment?*

FMLA refers to the Family and Medical Leave Act, which is a federal law that guarantees certain employees up to 12 workweeks of unpaid leave each year with no threat of job loss. FMLA also requires that employers covered by the law maintain the health benefits for eligible workers just as if they were working.

How did you hear about us?*

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Take the First Step Toward Recovery

Finding help for addiction is a courageous step. At Wooded Glen, we make that step easier with personalized care, compassionate staff, and proven treatment programs, all delivered in Indiana's safe, supportive environment.

(888) 351-0650 Send Us A Message