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Sliding scale agreement 2026
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- Click ‘Get Form’ to open the sliding scale agreement in the editor.
- Begin by reviewing the annual income brackets listed. Identify your income range and note the corresponding fees for both interns and licensed mental health professionals.
- If applicable, document any extenuating circumstances regarding your ability to pay in the designated area below the fee schedule.
- Read through the financial agreement section carefully. Ensure you understand that payment is due at the beginning of each session and note any fees associated with returned checks.
- Sign and date the form in the provided fields to confirm your agreement with the fee schedule.
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See more sliding scale versions
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2015 | 4.2 Satisfied (53 Votes) |
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