OPTION #1 (most popular)

Step 1: Download the Enrollment Packet (click here)

Step 2: Complete the paperwork

ALL of the following MUST be provided in order for us to complete the enrollment before seeing the patient:

  • Enrollment packet – filled out completely (hand write or type info)
  • Make sure the Patient, POA (Power of Attorney) or Legal Guardian signs all the required fields
  • of this enrollment packet
  • Copy of Insurance Card(s)
  • Current Medication List
  • POA/Guardianship documents

Step 3: Send it to the appropriate Crown Health office

Western Washington patients

1) FAX to: 206-694-2291

— OR —

2) UploadFor your convenience, you can upload your completed Enrollment Form & other documents here

— OR —

3) MAIL to:
Crown Health
23745 225th Way SE Suite 201
Maple Valley, WA 98038

Eastern Washington patients

1) FAX to: 509-232-5795

— OR —

2) UploadFor your convenience, you can upload your completed Enrollment Form & other documents here

— OR —

3) MAIL to:
Crown Health
12623 E Sprague Avenue Suite 6
Spokane Valley, WA 99216

 

OPTION #2 (for those tech savvy people)

Step 1: DocuSign – electronic enrollment (new!). This will enable you to fill out the entire enrollment form electronically. Send us an e-mail to get things started: bobbiejoc@crownhealthus.com
Step 2: Make copies of the Insurance Card(s), Current Medication List, POA/Guardianship documents
Step 3: See above – send copies of those documents to the appropriate Crown Health office (fax, upload or mail)

Please Note:

  • The enrollment process generally takes 2 weeks to finish.
  • The patient will continue with their current primary care provider until seen by Crown Health.

Please contact us if you have questions regarding the “Enrollment Process” at 888-674-5871 ext. 250 or by email rachaelb@crownhealthus.com

For a copy of the “Patient Disclosures and Acknowledgements” document, please click here.