Admissions

Addiction Treatment Admissions Process

Wondering how to get started with treatment at Boca Cove Detox? Let us guide you through the first steps on your recovery journey:

1. Contact us for a free insurance verification or to discuss self pay cost.
2. Complete an over the phone assessment to determine the best course of action for your addiction or alcoholism treatment.
3. Schedule your admission.

Client and Insurance Information

• Client Name*
• Client Date of Birth*
  MM slash DD slash YYYY
• Are you the primary insured on this policy?
  • Yes
  • No
• Primary Insured Name
• Primary Date of Birth
  MM slash DD slash YYYY
• Phone Number*
• Email Address
• Address
  Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
• Insurance Provider*
• Insurance Phone
• Insurance ID Number*
• Group ID Number*
• Type of Plan
• CAPTCHA
• Name
  This field is for validation purposes and should be left unchanged.