Insurance Verification

Find out if you qualify for $10 Co-Pay treatments

By filling out this form, we will be able to verify: that Kirk is an In Network Provider with your insurance plan, if your deductible has been waived because of that, also how many treatments you get per year (calendar or start date), what your co-pay is and if there are any restrictions on treatment in your policy.

Kirk and his Billing Company will get copies of this information only. His billing company will do their best to research your information and email Kirk that data within 2 business days sometimes sooner. Kirk will then call you with all the details and answer any questions you have. If you have not heard from us promptly, please send us a note. Kirk does work in 3 clinics and can use a reminder at times. If time is of the essence, please state that in the comments box at the end. Thank you.

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  • Please enter the member services phone number on the back of your insurance card. This helps us to contact the right department when verifying your insurance.