Does My Insurance Cover Forte Strong V.O.B. form Patient Name* First Last Patient Date of Birth* MM slash DD slash YYYY Policy Holder Name* First Last Policy Holder Date of Birth* MM slash DD slash YYYY Insurance Provider* United Healthcare requires that the patient/policy holder to call in and give permission for Forte Strong to obtain the out of network benefits for behavioral health services. In order to process this VOB request you will need to call in and give this permission for Forte Strong to verify your benefits. Insurance Policy #* Insurance Phone*Have you called United Healthcare for VOB permission?* Yes No Who Should We Send Results to?Policy HolderPatientRespondentName of Respondent* First Last Email Address* Phone Number*FRONT of Insurance Card*Max. file size: 50 MB.Please upload an image of the FRONT of your Insurance CardBACK of Insurance Card*Max. file size: 50 MB.Please upload an image of the FRONT of your Insurance Card Δ