Admissions - Colorado Addiction Recovery Services

Colorado Addiction Recovery Services is Proud to Accept Medicaid

You may contact us at any time with any questions at (843) 350-8552. You may also fill out the client and insurance information form found on this page. Once we receive your information, we will collect benefit information and contact you with information on what your insurance policy will cover for our program.

If at any time, you are in need of immediate emergency assistance, please contact 911.

Client and Insurance Information

First and Last Name of Client Seeking Treatment*
First Last
Client's Date of Birth*
Phone Number*
Email Address*
Name of Insurance Provider*
Member ID#*
Group ID#*
Plan Type*
- Private Insurance
- Medicaid
Emergency Contact Name*
First Last
Emergency Contact Phone Number
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Name
This field is for validation purposes and should be left unchanged.

Colorado Addiction Recovery Services is Proud to Accept Medicaid

Client and Insurance Information

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