Insurance Verification

Please enter the information requested below. The form has been divided into three sections for your convenience. Please note that required fields have been marked with an asterisk (*).

  • Parent Information

    Please fill up your personal and contact information below.
  • Child Information

    Please fill up the requested information about your child.
  • Insurance Information

    Please fill up your insurance information below.
  • Please verify you're human and add the numbers
Dr. from West Palm Beach
Thank you for doing such a good job evaluating and treating my kids. You and your team are truly making a difference in each one I send you (and that is not a compliment/comment that I frequently say). Thank you for all your help.