Miles Institute of Integral Living LLC

Integrated Human Development Facilitated By Integrated Human Beings

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Miles Institute provides a wide array of services to benefit the body, mind and spirit.

Please browse our website and use the form below to let us know how we can help you.

Request a Service (please answer all questions) We are not currently accepting Medicaid, however we do accept out of pocket payments. If interested, select "Out of Pocket" in the Health Insurance Provider section of the form.

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Email Address

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Sexual Orientation

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Health Insurance Provider

Please provide the amount of your Copay (it is your responsibility to know if you have a copay and/or deductible)

Please provide the amount of your Deductible (it is your responsibility to know if you have a copay and/or deductible)

Insurance Plan or Program Name (not your insurance provider but the kind of plan you have i.e. Healthy Choice, Gold etc.)

Insurance Member Number

Insurance Group Number

Is this your insurance policy or your parent or spouses policy? If you are not the primary policy holder, please provide the name, address, date of birth, employer and phone number of the primary policy holder.

Is your issue related to EAP? If so, please note your EAP number and any related information.

Please describe the challenge you are seeking assistance with.

Please indicate the days and times you are most available

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