top of page

Complete the form below and we'll get back to you as soon as possible!

Insurance Verification

Ready to get the ball rolling! Upload the needed documents to have your insurance verified. If you don't have insurance, we will get back to you with information about private pay rates.

Front of Insurance Card
Upload supported file (Max 15MB)
Back of Insurance Card
Upload supported file (Max 15MB)
Driver's License
Upload supported file (Max 15MB)

By signing below, I hereby grant BLISS Counseling & Consulting permission to contact me about my inquiry, create a client portal if I choose to move forward, and/or utilize the information listed above to verify my health insurance benefits.

The information provided will be used solely for the purpose of tracking the number of clients who are Tuskegee University (TU) students. No personal information will be shared, sold, or disclosed to any third party. We are committed to protecting your privacy and ensuring that your data remains confidential.

Once submitted, allow the page to process. Don't double submit.

Thanks for submitting!

If you have any issues submitting the form, please reach out to us directly at admin@balancelifecounseling.com. Provide your name, address, driver's license insurance card, and reasons for seeking therapy to get the ball rolling!

Let's Get Started

2231 Victory Lane Ste 700

Vestavia Hills, AL 35216

​

205-552-2370
  • Instagram
  • Facebook
tel1.jpg
bottom of page