SLIDING FEE PROGRAM

Extensive Medical Care

Our fees are discounted to all qualified patients. Specific conditions must be met and all appropriate documents must be submitted. Sliding fee calculations are based on income and size of household.

Proof of income is required to process your application. A copy of your most recent Federal Income Tax Return is strongly encouraged as proof of income. However, the documents listed below are also acceptable:

• W-2 forms

• Income tax returns

• Social Security notice

• Current pay stubs

• Unemployment award notice

• Letter from employer

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If you do not qualify for the sliding fee discount, or do not have all documentation, you will be responsible for paying full price. We accept cash, check and credit cards.