Discount Calculator

It is my policy to provide essential services regardless of your ability to pay. You must not have access to insurance coverage to qualify for a discount. Discounts are based on family income and size. Please complete the following information to determine if you or members of your family are eligible for a discount. The discount will apply to all services provided directly by me. In the hope that your financial situation improves, discounts apply only to current, not future services.

Please enter your annual family income. Include income from all sources including gross wages, tips, social security, disability, pensions, annuities, veterans payments, net business or self employment, alimony, child support, military, unemployment, and public aid.

Annual Family Income:

Please enter the number of people in your immediate family.

Family Size:

Discount = % (minimum charge of $10/hour)

Initial Consultation = $

Therapy 16-37 minutes = $

Therapy 38-52 minutes = $

Therapy 53-67 minutes = $