1234 Street Address City, ST 12345
888.529.2114
info@site.com
ConditionChemical DependencyPrimary Mental HealthDual Diagnosis (Both)
FinancialPPO InsuranceHMO InsuranceGovernment Employee InsuranceFederal Employee InsuranceUnion Health InsuranceAbility to Private PayWe Do Not Accept: Medi-care, Medi-Cal, IEHP
Who are you helping?I want to help myselfI want to help a loved oneI want to help a patient or clientI want to help an employee
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