Sliding Fee Program

As a Community Health Center, we have a special program called a Sliding Fee Program that can help make healthcare more affordable for you and your family. It works like this: based on how much money your family makes and how many people are in your family, you could end up paying only a part of the cost for most healthcare services. That means you may only have to pay between 20% and 80% of the total cost. Even if you already have insurance, you can still qualify for this program. To apply, you can get an application form from the front desk during your next appointment. Or you can click on the links below. Don’t worry, all the information you provide on the application will be kept private. If you need any help filling out the application, we have special staff members who can assist you.

Sliding Fee Application Packet – English

Sliding Fee Application Packet – Spanish

Sliding Fee Application Packet – Creole

Federal Poverty Guidelines will be used for the Sliding Fee Program. If your income falls within the guidelines, we encourage you to apply.

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