We accept Meritain Health (An Aetna Company) insurance plans through the City of Portland

Do you have a Meritain Health insurance plan through the City of Portland?

Please click the link below to submit your insurance information in advance of your appointment.

** All copays are due at the time of service, and clients are responsible for any payments not covered by their plan. **

Submit Insurance Info

Name

First Name

Last Name

Date of Birth

YYYY

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Relationship to Policy Subscriber

Is the policy subscriber your:

Policy Subscriber Name (if other than you)

Policy Subscriber Date of Birth (if other than you)

Member ID

Group ID

Is this your primary insurance?

We can not accept secondary insurance at this time.

Have you used your insurance for massage therapy benefits elsewhere during this calendar year?

Electronic Signature

Please enter your full name here as your signature to give permission to release this information to the insurance company on your behalf.

First Name

Last Name