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  • The acetaminophen component in Vicodin can on its own put the user at risk of overdose.
  • Methamphetamine causes a release of high levels of dopamine into the areas of the brain that have to do with the feeling of pleasure and reward, which is why the drug is so addictive.
  • Nearly 70 percent of State and 57 percent of Federal prisoners have used drugs regularly prior to incarceration.
  • Long term effects of heavy hashish use can include irritation to the lungs, risk of developing chronic bronchitis and an increased risk of developing cancer of the respiratory tract.

GET HELP LOCATING A DRUG TREATMENT PROGRAM

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Private Health Insurance - Portland, OR.

Covering the cost of drug treatment in Portland, OR. is often a matter of great discussion when enrolling into treatment. Since drug addiction regularly takes away everything that the addict has labored for it can be very difficult to cover the out of pocket cost of a substance abuse program. Addicts who are able to utilize private health insurance to cover their treatment expenses are at an excellent advantage. These days, many programs consider numerous types of private health insurance and you are likely to find a program to meet your recovery requirements. When you are studying what drug rehab you are going to go to, the very first step will be contacting your insurance company and discovering what coverage is offered to you and what programs they are contracted with.

  • Tigard Comprehensive Trt Center
    Tigard Comprehensive Trt Center is located at:

    10763 SW Greenburg Road
    Portland, OR. 97223

    If you would like to contact Tigard Comprehensive Trt Center, you can reach them at 503-684-8159.

    Tigard Comprehensive Trt Center offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Persons With Hiv/Aids, Gays And Lesbians, Seniors/Older Adults, Pregnant/Postpartum Women, Women, Men, Criminal Justice Clients
    Payment forms accepted: Self Payment, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare), Sliding Fee Scale (Fee Is Based On Income And Other Factors)
  • OHSU Avel Gordly Center for Healing
    OHSU Avel Gordly Center for Healing is located at:

    621 SW Alder Street
    Portland, OR. 97205

    If you would like to contact OHSU Avel Gordly Center for Healing, you can reach them at 503-494-4745.

    OHSU Avel Gordly Center for Healing offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance
  • Oregon Health and Science University
    Oregon Health and Science University is located at:

    3181 SW Sam Jackson Park Road
    Portland, OR. 97239

    If you would like to contact Oregon Health and Science University, you can reach them at 503-494-6053.

    Oregon Health and Science University offers the following treatment services: Hospital Inpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Adventist Medical Center
    Adventist Medical Center is located at:

    10123 SE Market Street
    Portland, OR. 97216

    If you would like to contact Adventist Medical Center, you can reach them at 503-257-2500.

    Adventist Medical Center offers the following treatment services: Hospital Inpatient, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Providence Outpatient Mental Health
    Providence Outpatient Mental Health is located at:

    9450 SW Barnes Road
    Portland, OR. 97225

    If you would like to contact Providence Outpatient Mental Health, you can reach them at 503-216-2025.

    Providence Outpatient Mental Health offers the following treatment services: Outpatient, Partial Hospitalization/Day Treatment, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Willamette Rose RTF
    Willamette Rose RTF is located at:

    12505 SE Raymond Street
    Portland, OR. 97236

    If you would like to contact Willamette Rose RTF, you can reach them at 541-858-8170.

    Willamette Rose RTF offers the following treatment services:
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Oregon Trail Recovery LLC
    Oregon Trail Recovery LLC is located at:

    10600 SE McLoughlin Boulevard
    Portland, OR. 97222

    If you would like to contact Oregon Trail Recovery LLC, you can reach them at 877-770-0577.

    Oregon Trail Recovery LLC offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Women, Men, Dui/Dwi Offenders, Criminal Justice Clients
    Payment forms accepted: Self Payment, Private Health Insurance
  • Cedar Hills Hospital
    Cedar Hills Hospital is located at:

    10300 SW Eastridge Street
    Portland, OR. 97225

    If you would like to contact Cedar Hills Hospital, you can reach them at 503-944-5000.

    Cedar Hills Hospital offers the following treatment services: Hospital Inpatient, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicare, Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Belmont Comprehensive Treatment Center
    Belmont Comprehensive Treatment Center is located at:

    2600 SE Belmont Street
    Portland, OR. 97214

    If you would like to contact Belmont Comprehensive Treatment Center, you can reach them at 866-229-9587.

    Belmont Comprehensive Treatment Center offers the following treatment services: Substance Abuse Treatment Services, Detoxification, Methadone Detoxification, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Pregnant/Postpartum Women, Women, Men, Criminal Justice Clients
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors)
  • Providence St. Vincent Med Ctr
    Providence St. Vincent Med Ctr is located at:

    9205 SW Barnes Road
    Portland, OR. 97225

    If you would like to contact Providence St. Vincent Med Ctr, you can reach them at 503-216-1234.

    Providence St. Vincent Med Ctr offers the following treatment services: Hospital Inpatient, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Integrated Health Clinics LLC
    Integrated Health Clinics LLC is located at:

    17882 SE Mcloughlin Boulevard
    Portland, OR. 97267

    If you would like to contact Integrated Health Clinics LLC, you can reach them at 503-353-9415.

    Integrated Health Clinics LLC offers the following treatment services: Substance Abuse Treatment Services, Detoxification, Methadone Detoxification, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Gays And Lesbians, Seniors/Older Adults, Pregnant/Postpartum Women, Women, Men, Dui/Dwi Offenders, Spanish
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance
  • Providence Portland Medical Center
    Providence Portland Medical Center is located at:

    5228 NE Hoyt Street
    Portland, OR. 97213

    If you would like to contact Providence Portland Medical Center, you can reach them at 503-215-6474.

    Providence Portland Medical Center offers the following treatment services: Partial Hospitalization/Day Treatment, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare), Payment Assistance (Check With Facility For Details)
  • Modus Vivendi LLC
    Modus Vivendi LLC is located at:

    1000 NE 122nd Avenue
    Portland, OR. 97230

    If you would like to contact Modus Vivendi LLC, you can reach them at 503-781-9065.

    Modus Vivendi LLC offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Women, Men, Dui/Dwi Offenders, Criminal Justice Clients, Spanish, Other Languages
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors)
  • CRC Allied Health Services
    CRC Allied Health Services is located at:

    324 NW Davis Street
    Portland, OR. 97209

    If you would like to contact CRC Allied Health Services, you can reach them at 503-226-2203.

    CRC Allied Health Services offers the following treatment services: Substance Abuse Treatment Services, Outpatient
    Payment forms accepted: Self Payment, Medicaid, Private Health Insurance
  • East Comprehensive Treatment Center
    East Comprehensive Treatment Center is located at:

    6601 NE 78th Court
    Portland, OR. 97218

    If you would like to contact East Comprehensive Treatment Center, you can reach them at 503-252-3949.

    East Comprehensive Treatment Center offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Persons With Hiv/Aids, Gays And Lesbians, Seniors/Older Adults, Pregnant/Postpartum Women, Women, Men, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Private Health Insurance
  • Puentes
    Puentes is located at:

    12672 South East Stark Street
    Portland, OR. 97233

    If you would like to contact Puentes, you can reach them at 503-546-9975.

    Puentes offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Adolescents, Persons With Co-Occurring Mental And Substance Abuse Disorders, Women, Men, Dui/Dwi Offenders, Criminal Justice Clients, Spanish
    Payment forms accepted: Self Payment, Medicaid, Private Health Insurance
  • Advance Treatment Center LLC
    Advance Treatment Center LLC is located at:

    18210 East Burnside Street
    Portland, OR. 97233

    If you would like to contact Advance Treatment Center LLC, you can reach them at 503-766-2582.

    Advance Treatment Center LLC offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Adolescents, Persons With Hiv/Aids, Seniors/Older Adults, Women, Men, Dui/Dwi Offenders, Criminal Justice Clients, Spanish
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors), Payment Assistance (Check With Facility For Details)
  • Recovery Works NW LLC
    Recovery Works NW LLC is located at:

    12540 SW Main Street
    Portland, OR. 97223

    If you would like to contact Recovery Works NW LLC, you can reach them at 503-906-9995.

    Recovery Works NW LLC offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Dui/Dwi Offenders
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Native American Rehabilitation
    Native American Rehabilitation is located at:

    17645 NW St. Helens Highway
    Portland, OR. 97231

    If you would like to contact Native American Rehabilitation, you can reach them at 503-621-1069.

    Native American Rehabilitation offers the following treatment services: Substance Abuse Treatment Services, Residential Long-Term Treatment (More Than 30 Days), Persons With Co-Occurring Mental And Substance Abuse Disorders, Pregnant/Postpartum Women, Women, Men, Residential Beds For Clients Children, Asl Or Other Assistance For Hearing Impaired, Spanish, Native American Or Alaska Native Languages
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors), Payment Assistance (Check With Facility For Details)
  • De Paul Treatment Centers Inc
    De Paul Treatment Centers Inc is located at:

    4310 NE Killingworth Street
    Portland, OR. 97208

    If you would like to contact De Paul Treatment Centers Inc, you can reach them at 503-535-1181.

    De Paul Treatment Centers Inc offers the following treatment services: Substance Abuse Treatment Services, Detoxification, Outpatient, Residential Short-Term Treatment (30 Days Or Less), Residential Long-Term Treatment (More Than 30 Days), Adolescents, Persons With Co-Occurring Mental And Substance Abuse Disorders, Gays And Lesbians, Criminal Justice Clients, Asl Or Other Assistance For Hearing Impaired, Spanish
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors)
  • Cameron Care Inc
    Cameron Care Inc is located at:

    3626 NE Garfield Avenue
    Portland, OR. 97212

    If you would like to contact Cameron Care Inc , you can reach them at 503-249-6998.

    Cameron Care Inc offers the following treatment services:
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance
  • Oregon Health Science University
    Oregon Health Science University is located at:

    621 SW Alder Street
    Portland, OR. 97205

    If you would like to contact Oregon Health Science University , you can reach them at 503-494-4745.

    Oregon Health Science University offers the following treatment services: Outpatient, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Private Health Insurance
  • Catholic Community Services
    Catholic Community Services is located at:

    1904 SE Division Street
    Portland, OR. 97202

    If you would like to contact Catholic Community Services, you can reach them at 503-517-8663.

    Catholic Community Services offers the following treatment services: Outpatient, Spanish
    Payment forms accepted: Medicaid, Private Health Insurance
  • Providence St. Vincent Medical Ctr
    Providence St. Vincent Medical Ctr is located at:

    9450 SW Barnes Road
    Portland, OR. 97225

    If you would like to contact Providence St. Vincent Medical Ctr, you can reach them at 503-216-2057.

    Providence St. Vincent Medical Ctr offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Seniors/Older Adults, Women, Men, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Serenity Lane
    Serenity Lane is located at:

    10920 SW Barbur Boulevard
    Portland, OR. 97219

    If you would like to contact Serenity Lane, you can reach them at 503-244-4500.

    Serenity Lane offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Women, Men
    Payment forms accepted: Self Payment, State Financed Insurance (Other Than Medicaid), Private Health Insurance
  • Trillium Family Services
    Trillium Family Services is located at:

    3415 SE Powell Boulevard
    Portland, OR. 97202

    If you would like to contact Trillium Family Services, you can reach them at 503-234-9591.

    Trillium Family Services offers the following treatment services: Outpatient, Gays And Lesbians, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance
  • Ram Clinic
    Ram Clinic is located at:

    3610 NE 82nd Street
    Portland, OR. 97220

    If you would like to contact Ram Clinic, you can reach them at 503-408-9585.

    Ram Clinic offers the following treatment services: Substance Abuse Treatment Services, Detoxification, Methadone Detoxification, Outpatient, Spanish
    Payment forms accepted: Self Payment, Medicaid, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Outside In
    Outside In is located at:

    1132 SW 13th Avenue
    Portland, OR. 97205

    If you would like to contact Outside In, you can reach them at 503-535-3800.

    Outside In offers the following treatment services: Substance Abuse Treatment Services, Outpatient
    Payment forms accepted: Self Payment, Medicaid, Medicare, Private Health Insurance
  • Teras Intervention and Counseling Inc
    Teras Intervention and Counseling Inc is located at:

    3945 SE Hawthorne Boulevard
    Portland, OR. 97214

    If you would like to contact Teras Intervention and Counseling Inc, you can reach them at 503-719-5250.

    Teras Intervention and Counseling Inc offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Women, Men, Dui/Dwi Offenders, Criminal Justice Clients
    Payment forms accepted: Self Payment, Medicaid, Private Health Insurance
  • Acadia Northwest
    Acadia Northwest is located at:

    10101 SW Barbur Boulevard
    Portland, OR. 97219

    If you would like to contact Acadia Northwest, you can reach them at 503-245-6262.

    Acadia Northwest offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Gays And Lesbians, Seniors/Older Adults, Women, Men, Dui/Dwi Offenders, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Astrue and Associates LLC
    Astrue and Associates LLC is located at:

    511 SW 10th Avenue
    Portland, OR. 97205

    If you would like to contact Astrue and Associates LLC, you can reach them at 503-220-0520.

    Astrue and Associates LLC offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Gays And Lesbians, Women, Men, Dui/Dwi Offenders
    Payment forms accepted: Self Payment, Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Legacy Emanuel Hospital and Health Ctr
    Legacy Emanuel Hospital and Health Ctr is located at:

    2801 North Gantenbein Avenue
    Portland, OR. 97227

    If you would like to contact Legacy Emanuel Hospital and Health Ctr, you can reach them at 503-413-2200.

    Legacy Emanuel Hospital and Health Ctr offers the following treatment services: Hospital Inpatient, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Cascadia Behavorial Healthcare
    Cascadia Behavorial Healthcare is located at:

    3034 NE Martin Luther King Jr Blvd
    Portland, OR. 97212

    If you would like to contact Cascadia Behavorial Healthcare, you can reach them at 503-283-3763.

    Cascadia Behavorial Healthcare offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Adolescents, Persons With Co-Occurring Mental And Substance Abuse Disorders, Dui/Dwi Offenders, Criminal Justice Clients, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors), Payment Assistance (Check With Facility For Details)
  • Lutheran Community Services NW
    Lutheran Community Services NW is located at:

    605 SE Cesar E Chavez Boulevard
    Portland, OR. 97214

    If you would like to contact Lutheran Community Services NW, you can reach them at 503-231-7480.

    Lutheran Community Services NW offers the following treatment services: Outpatient, Spanish, Other Languages
    Payment forms accepted: Self Payment, Medicaid, Medicare, Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors)
  • Cascadia Behavioral Healthcare
    Cascadia Behavioral Healthcare is located at:

    2415 SE 43rd Avenue
    Portland, OR. 97206

    If you would like to contact Cascadia Behavioral Healthcare, you can reach them at 503-230-9654.

    Cascadia Behavioral Healthcare offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Gays And Lesbians, Women, Men, Dui/Dwi Offenders, Criminal Justice Clients, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors), Payment Assistance (Check With Facility For Details)
  • Volunteers of America of Oregon
    Volunteers of America of Oregon is located at:

    2318 NE Martin Luther King Jr Blvd
    Portland, OR. 97212

    If you would like to contact Volunteers of America of Oregon, you can reach them at 503-335-8611.

    Volunteers of America of Oregon offers the following treatment services: Substance Abuse Treatment Services, Halfway House, Outpatient, Residential Long-Term Treatment (More Than 30 Days), Persons With Co-Occurring Mental And Substance Abuse Disorders, Men, Dui/Dwi Offenders, Criminal Justice Clients
    Payment forms accepted: Self Payment, Medicaid, Medicare, Private Health Insurance
  • CODA Inc
    CODA Inc is located at:

    1427 SE 182nd Avenue
    Portland, OR. 97233

    If you would like to contact CODA Inc, you can reach them at 503-761-6006.

    CODA Inc offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Residential Short-Term Treatment (30 Days Or Less), Residential Long-Term Treatment (More Than 30 Days), Persons With Co-Occurring Mental And Substance Abuse Disorders, Pregnant/Postpartum Women, Women, Men, Residential Beds For Clients Children, Criminal Justice Clients
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Arbor Place Secure Treatment Facility
    Arbor Place Secure Treatment Facility is located at:

    2330 NE Siskiyou Street
    Portland, OR. 97212

    If you would like to contact Arbor Place Secure Treatment Facility, you can reach them at 503-528-0757.

    Arbor Place Secure Treatment Facility offers the following treatment services:
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance
  • Legacy Good Samaritan Hospital and
    Legacy Good Samaritan Hospital and is located at:

    1015 NW 22nd Avenue
    Portland, OR. 97210

    If you would like to contact Legacy Good Samaritan Hospital and, you can reach them at 503-413-7711.

    Legacy Good Samaritan Hospital and offers the following treatment services: Hospital Inpatient, Persons With Co-Occurring Mental And Substance Abuse Disorders, Persons With Hiv/Aids, Gays And Lesbians, Seniors/Older Adults, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Military Insurance (E.G., Va, Tricare)
  • Central City Concern Recovery Center
    Central City Concern Recovery Center is located at:

    726 West Burnside Street
    Portland, OR. 97205

    If you would like to contact Central City Concern Recovery Center, you can reach them at 503-944-4410.

    Central City Concern Recovery Center offers the following treatment services: Substance Abuse Treatment Services, Outpatient, Women, Men
    Payment forms accepted: Self Payment, Medicaid, Medicare, State Financed Insurance (Other Than Medicaid), Private Health Insurance, Sliding Fee Scale (Fee Is Based On Income And Other Factors), Payment Assistance (Check With Facility For Details)
  • Albertina Kerr Centers
    Albertina Kerr Centers is located at:

    722 NE 162nd Avenue
    Portland, OR. 97230

    If you would like to contact Albertina Kerr Centers, you can reach them at 503-239-8101.

    Albertina Kerr Centers offers the following treatment services: Outpatient, Gays And Lesbians, Asl Or Other Assistance For Hearing Impaired
    Payment forms accepted: Self Payment, Medicaid, Private Health Insurance