Health Insurance Verification - The Blanchard Institute

By taking a few simple steps, you can get the verification process out of the way and start focusing on your recovery. For more information on your insurance coverage please fill out our insurance verification form and we will get back to you as soon as possible. We are part of preferred networks with most insurance companies including Blue Cross Blue Shield Of North Carolina.

Complete the quick verification form below to find out if your insurance plan covers our services.

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Client Information

Name of Person Completing Form

Phone Number of Person Completing Form

Client First Name*

Client Last Name*

Client Date of Birth*

Email*

Phone*

Policy Holder Information

Policy Holder Name*

Policy Holder Last Name*

Insurance Company*

Insurance Phone Number*

Policy Number*

Group Number*

Address of Policy Holder*

Street Address Address Line 2 City State ZIP Code

Organization/Professional who referred you:

Client Information

Policy Holder Information

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