Documents

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. Dr Crow’s office is primarily private pay. He takes only Blue Cross / Blue Shield Insurance. He does not take Medicare. Diagnosis can affect reimbursement and will be discussed in the initial session. If you have any questions about this, please contact Sandy at: 623-572-4128 between the hours of 8am and 12pm Monday-Friday.

Treatment Agreement

Life Functioning Inventory

Authorization for Information Release

Map To Office

Privacy Policy