We will try to give you healthcare regardless of insurance. If you have no medical or dental insurance, please call prior to your appointment to talk about our sliding fee scale. You may be eligible for reduced rates based on your family’s size and income. All payments and co-payments are to be payed at the time of service.

To apply for our sliding fee program, complete the application below.

You must provide proof of all household income and residency. Please see attached Documentation checklist. Failure to provide sufficient proof will result in the return of your application and delay in approval.

Sliding Fee application in Microsoft Word Format

Sliding Fee application in PDF format