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SLIDING SCALE FEE PROGRAM

Accepted documents for proof of income:

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  •  Current Federal Income Tax (1040-1040 EZ Form, no W2s)

  •  Paystubs for recent month 

  •  Current bank statement showing direct deposit (SS, SSI, SSD, Child support) 

  •  Social Security/Disability Letter

  •  Unemployment Benefit Letter (no bank statements)

  •  Letter of Support

  •  Court order for alimony or child support or printout for child support payments 

  •  Pension Benefit Letter

  •  Wages (4 pay stubs if paid weekly, 2 pay stubs if paid bi-weekly)

  •  Please note, we require tax documents for individuals who are self-employed. 

Drug Treatment, Alcohol Treatment, Outpatient IOP
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