Benefits

Please fill out this confidential form so that we can verify your current insurance plan’s TMS Therapy benefits.

 
 

 
 
Member Name *
Member Name
Select your current insurance carrier
Please write in the member ID on your insurance card
(MM/DD/YYYY)
Have You Previously Been Prescribed Antidepressants? *

REFERENCE MEDICATIONS GUIDE HERE

By hitting submit, you are agreeing to our Benefits & HIPAA policy.

 
 

 

ACCESS TO All Major Carriers!

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