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At Windward Way, we accept most types of private insurance and offer a variety of payment options. Complete the form to privately check your insurance provider benefits for addiction treatment services. This means your treatment may be FREE¹ depending on your policy, copay, and deductible.

General Information
Who Is This For?*
Patient Full Name*
Patient Date of Birth*
Subscriber Full Name*
Subscriber Date of Birth*
Email*
Home/Cell Phone Number*
How did you hear about us?*
Address
Address on file with your insurance carrier.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Insurance Information
Insurance Carrier*
Insurance ID #*
Provider Services Phone # (on back of card)*
Group ID #
Type of Plan
- PPO
- HMO
- EPO
- POS
- Unknown
Is this a COBRA Policy?
- Yes
- No
- Unknown
Photo Upload: FRONT of Insurance Card (optional)
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.
Photo Upload: BACK of Insurance Card (optional)
Max. file size: 50 MB.
Additional Information
Have You Been to Treatment Before?
Brief Description of Your Problem
Comments
When and how is the best way to contact you?
Email
This field is for validation purposes and should be left unchanged.

By submitting this form you agree to the terms of use and privacy policy of the website. An admissions counselor will contact you in a timely manner.

1 Insurance Disclaimer: Windward Way will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a verification of benefits and/or authorization. Your health insurance provider will be able to provide accurate and complete payment and verification eligibility. We cannot independently guarantee this information. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” Windward Way will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.

Five stars aren’t enough! I’d give Windward Way 10 stars if it was possible! EVERY person we worked with was not only professional but caring and supportive. The clinical staff are knowledgeable and provide consistent quality treatment. The administrative staff are efficient, friendly and work in a timely manner. I can’t say enough good things about Windward Way.

— C. G.
I absolutely loved this place!! Didn't know what I was getting myself into but I would recommend this treatment center to anyone..the staff is very supportive friendly like family!! The groups are very informative and so helpful please please if you're looking for help with your addiction chose Windward Way!! ❤

— Lisa B.

Medical Disclaimer: Windward Way Recovery uses fact-based content about recovery treatment, addiction medicine, and behavioral health conditions in order to improve the quality of life for those struggling with drug and alcohol addiction or mental health disorders. While the information provided is researched and reviewed by licensed medical professionals, it is not intended to replace professional medical guidance, diagnosis, care, or treatment. This information should not be used as a substitute for advice from a qualified healthcare provider and/or your physician.

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