Treatment Forms
Patient Admission Forms
Thank you for choosing InnerBalance Health Center for your addiction recovery needs. We look forward to partnering with you and your loved ones to reach whole healing.
Here you will find valuable information that will walk you through the admissions process.
Confidential Assessment Form
Please complete this assessment form prior to your stay with us. This will help us better understand your background and personalize your treatment program to your needs.
Insurance Verification Form
**Optional** Must be completed prior to admission!
If you are unsure about what your insurance company may or may not cover, complete this form and we will help you to verify coverage. We do not accept Medicare/Medicaid.
Program Deposit Form
Use this form to read our deposit policy and submit your online payment securely and confidentially.
Preparing For Arrival
Here you will find all the information to prepare for your addiction treatment stay including welcome documentation, what items to bring with you and other necessary information.
Once you have completed the Assessment Form, please download our welcome packet to complete your registration.
Welcome Packet
Our welcome packet includes a welcome letter, our guidelines for acceptance, info about your deposit and notice to family members.
What To Bring For Your Stay:
- Comfortable, casual clothing and shoes
- Clothing you can layer – Colorado temperatures fluctuate
- Exercise clothing & shoes (bring an extra pair of outdoor shoes in case one gets dirty or wet)
- Sleep wear – robe, pajamas, slippers
- Personal toiletries
- Swimsuit
- Day pack
- Sunglasses & sunscreen
- During winter months, please bring snow boots, hat, scarf, coat, gloves, hat, etc. as you will be walking between our residence and office. You will also participate in an outdoor field trip that requires light hiking and weather may vary.
What NOT to Bring For Your Stay:
- Smart Watches
- Bicycles
- Opened packs of cigarettes or used vape pens and cartridges
Optional Items To Bring:
If you have the following and would like to bring along:
- Laptop
- Cell phone (Not allowed during treatment and restricted 2-hour access at completion of day)
- Inspirational reading
- iPod’s or MP3 players (to use at the gym or walks since you will not have your cell phone during the day)
- Headphones or earbuds
- Recreational equipment – golf clubs, roller blades, fishing rod, playing cards, board games…
- Camera
- Stationery, envelopes, stamps
- Basic watch for telling time outside of the facilities
- If over 21, you may bring unopened/new packages of cigarettes, vape pens, and cartridges.
Client Dress Code Policy:
Please do not wear any of the following during your stay with InnerBalance Health Center
- Torn clothing
- Clothing with foul language or obscene images
- Clothing with images/sayings that are alcohol or drug related
- Excessively tight or short clothing (shorts need to be mid-thigh length)
- See-through clothing
- Bare midriff shirts
- Exposed undergarments
- Strapless shirts
If a client’s dress is in violation of this policy, the client will be asked to make an appropriate correction.
Family Program Enrollment
For friends and family that are looking to gain insights and knowledge in helping your loved ones achieve a life of sobriety, we offer an optional intensive 3-day Family Program. Learn more about our family program here.
Family Program Enrollment
If you are ready to sign-up and reserve space in our upcoming Family Program sessions, have each family member complete our online form.
Post Treatment Opportunities
For friends and family that are considering our after care services, please complete the form below.
Post Treatment Form
If you are ready to sign-up and reserve space in our post treatment care sessions, complete our online form.
Financing Options
