How do I pay for treatment?

Crossroads is in network with most major insurances to cover the cost of treatment. Crossroads also accepts self-pay and offers a competitive self-pay rate. Through the compassionate generosity of past patients and their families, a limited amount of financial assistance may be available to those who meet the financial needs assessment criteria. To learn more about financial assistance, talk with our admissions staff. Full scholarships are not offered.

Our admissions specialists will help

Please complete the form below as completely as possible. One of our admissions specialists will verify your benefits and contact you. Or call 877.978.1667.

Your Contact Information
Your Name*
First Last
Return Callback Phone Number*
Email*
Can we leave a message?*
- Yes
- No
Who is seeking treatment?*
- Yourself
- A Loved One
Are you inquiring about Residential or Outpatient treatment?*
- Residential
- Outpatient
How did you hear about us?
Is there any additional information you would like to share?
Loved One's Information
Your Information
Loved One's Name*
First Last
Loved One's Date Of Birth*
MM slash DD slash YYYY
Your Date Of Birth*
MM slash DD slash YYYY
Additional Information
Insurance Information
Would you like us to verify your or a loved one's insurance benefits?*
- Yes
- No
Policy Holder's Name*
First Last
Policy Holder's Date Of Birth*
MM slash DD slash YYYY
Insurance Company's Name*
Insurance Company's Phone Number*
Member ID*
Group Number*
Policy Holder's Relationship to Client

Your Contact Information

Loved One's Information

Your Information

Insurance Information

You deserve a second chance. Contact Crossroads today!

877.978.1667

Make an Appointment

877.978.1667

How Do I Pay?

How do I pay for treatment?

Our admissions specialists will help

Your Contact Information

Loved One's Information

Your Information

Insurance Information

You deserve a second chance. Contact Crossroads today!

877.978.1667

Make an Appointment

877.978.1667