I AM LOOKING FOR HELP FOR *

GET HELP FOR YOU OR YOUR LOVED ONE IN UNDER 2 MINUTES. WE WILL CHECK YOUR HEALTH INSURANCE BENEFITS FOR FREE.

WHO NEEDS TO GET HELP TODAY?

 
WHAT ARE YOU STRUGGLING WITH *

PLEASE CHOSE WHAT YOU OR YOUR LOVED ONE ARE HAVING A PROBLEM WITH

 
WHAT DESCRIBES YOUR CURRENT SITUATION *

Lets get you help for  {{answer_FKjckMVDskt9}}   If not now then when?

SELECT OPTION BELOW

 
FIRST NAME OF PERSON THAT NEEDS HELP *

Lets get you the help you need for your  {{answer_FKjckMVDskt9}} problem. Your {{answer_nrxeSfYt2oGy}} Health Insurance may cover 100% of the costs of treatment.

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LAST NAME OF PERSON THAT NEEDS HELP *

{{answer_sckQvi6Hx8vT}} we need your last name to verify what your {{answer_nrxeSfYt2oGy}} Health Insurance will cover for your treatment.

GETTING CLOSE. PLEASE ENTER YOUR LAST NAME BELOW
 
{{answer_sckQvi6Hx8vT}} we are checking to see what your {{answer_nrxeSfYt2oGy}} Health Insurance covers for your treatment of  {{answer_FKjckMVDskt9}} substance abuse. This will only take a few seconds! 

You or Your Loved One Don’t Have To Feel This Way Anymore. Lets get you the  Help You Need. Click CHECK MY COVERAGE below to continue. 

 
VERIFICATION STEP *

{{answer_sckQvi6Hx8vT}} Your {{answer_nrxeSfYt2oGy}}  Health Insurance needs to verify your coverage for you or your loved ones {{answer_FKjckMVDskt9}} addiction. To receive your verification by text please enter your Phone Number below.

WE MAY HAVE SOME ADDITIONAL QUESTIONS. PLEASE ENTER THE BEST NUMBER TO REACH YOU AT.

ENTER PHONE NUMBER BELOW:
 
{{answer_sckQvi6Hx8vT}} Please click I Accept to Verify Your Benefits. *

By clicking the button “I Accept” you verify your information is correct and consent to receive your insurance verification of benefits information to the email you have provided. You may also receive a text message at the telephone number you provided above confirming your request from Wave Lengths Recovery. You may also receive your Insurance verification of benefits by contacting us via phone. You may receive phone calls from our automated dialer system. You may revoke this consent at any time by contacting us via phone to be placed on our do-not-call list. Your carrier's message and data rates may apply. Wave Lengths Recovery does not charge you for sending or receiving text messages. By using this form you agree to the terms of our privacy policy.

FINAL STEP LETS GET YOU THE HELP YOU NEED. CLICK I ACCEPT TO CONTINUE.
     
{{answer_sckQvi6Hx8vT}}  YOU HAVE TAKEN YOUR FIRST STEP TOWARD RECOVERY. CLICK FINISH BELOW. PLEASE SHARE ON FACEBOOK. 

CLICK THE ORANGE BUTTON BELOW TO COMPLETE THE PROCESS.

YOU MAY RECEIVE A PHONE OR TEXT MESSAGE FROM OUR ADMISSION TEAM.  
CLICK HERE TO FINISH