The following forms must be reviewed, filled out(as necessary)and signed or initialed where indicated prior to your first session with me. Doing this work in advance will save valuable time in the office. Please click on each link below to print the forms:
IMPORTANT: Our office is a fee-for-service office(private pay). Clients receive a receipt at each session which they may file to their insurance company for reimbursement. Our office does not bill insurance and Dr. crow does not take insurance or do managed care, so all reimbursement issues are the responsibility of the client. Diagnosis can affect reimbursement and will be discussed in the initial session. In addition, Dr. Crow is not currently taking medicare patients and medicare does not allow private pay. If you have any questions about this, please contact Sandy at: 623-572-4128 between the hours of 8 and 12 noon Monday-Friday.
Treatment agreement
Life functioning inventory
Authorization for information release
Privacy policy
