Sliding fee scale discounts program (SFSDP)

• Patients may be eligible to receive a sliding fee scale discount for services. Eligibility for the sliding fee scale discount is based on family size and income. Please bring verification of all sources of income for all adult members of your family. We will determine the discount for which you are eligible.

We accept the following documents as income verification:

• Income tax returns

• A letter from your employer verifying your employment and pay rate

• Check stubs from current employer(s)

• Social Security, disability, retirement or veterans benefit statements

• Alimony

• Military benefits

• Unemployment benefit statements

• W-2 form(s)

• 1099 form(s)

• Nursing home, assisted living income verification form

• Self-declaration of no income — a zero income affidavit signed by the patient and/or family members