We work with many leading insurance providers. Fill out the form below to find out if your insurance company will cover your treatment costs at SpringBoard. Verify insurance Have your insurance card handy You’ll need it to complete this form. Your Name Your Email Your Relation To Patient I'm the patientI'm the patient's spouseI'm the patient's motherI'm the patient's fatherI'm the patient's brotherI'm the patient's sisterI'm the patient's childI'm the patient's other relative (*) Required Field Insurance Policy Holder (The primary person on the insurance policy) Primary Insured Name (*) Primary Insured Date of Birth (*) Primary Insured Email Primary Insured Phone (*) Your information is SSL encrypted Patient Information (The person that needs treatment) Patient First Name (*) Patient Last Name (*) Patient Phone (*) Insurance Information Insurance Provider (*) Patient Date of Birth (*) Insurance Phone (*) Insurance ID Number (*) Group ID Number (*) Type of Plan (*) EPO PlanHMO PlanPOS PlanPPO PlanOther Plan Additional information Submit See Our Privacy Policy This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.