Sliding Scale Application – Angela Blueskies

Angela’s client schedule is full at this time, and all sliding scale slots are filled. Angela maintains two sliding scale slots in her schedule at any given time, and sliding scale eligibility is renewed either once per year for clients scheduling regular sessions at least once per month, and for clients scheduling intermittently, after any 6 month gap in sessions. Any sliding scale clients that schedule less frequently than once in any 6 month period must reapply, and depending on demand, may have to rejoin the wait list.

If you wish to be considered for sliding scale sessions, please complete the form below, and also join the waitlist here. Your application will be reviewed upon submission, and you will be notified once the application is approved or declined. If approved, you will be added to the sliding scale waitlist.

Keeping my work accessible is an important part of my mission. I offer a limited number of need-based sliding scale appointments in my practice for clients who qualify as officially low-income, and to whom this work would be otherwise inaccessible. I ask people who are interested in working with me on a sliding scale to answer a few questions. This helps us discern between genuine need and a strong preference for a reduced fee. I understand that frank discussions about resources may be uncomfortable, and it is only through honest, transparent disclosure that I may offer a lower rate to those who truly need it, while maintaining a practice that is financially sustainable as well.

In order to be considered for sliding scale sessions, please complete the form below. All your answers will be kept completely confidential. Please note that if you own a home, earn wages that are greater than 150% of the poverty line for your location (which defines the parameters for “low-income”), have significant savings/investments, or have an earning partner, you do not qualify for sliding scale.

If you do not qualify for sliding scale, there are other ways to decrease the cost of this work. For example: paying for a package of sessions at a discounted rate, or doing 60 min sessions vs. 90 min sessions. If you are interested in these options, please let me know.

If you are approved for sliding scale sessions, you will receive an email notification with further instructions on scheduling and submitting payment. You must book your initial session within one week of approval. The online scheduler allows bookings within the upcoming window of two months. Those who do not book within one week of approval will be dropped from Angela’s sliding scale client list, and will not be eligible to reapply.

Sliding scale rates are:
$175 – $250 for new client package (1 x 90 min and 2 x 60 min)
$50-75 for follow up sessions (60 min only)
All sliding scale payments may be submitted via Venmo or Zelle, or using Wise for non-US clients, and payment must be submitted prior to scheduling.

If you meet the above conditions and would like to apply for sliding scale, please complete your application by answering the following questions. Your information will be held in confidentiality.

First Name*

Last Name*

Email*

Phone*

1) What was your annual gross income for the past two years? (Line 22 of your 1040 form.) Non-US clients, please indicate your annual gross income (pre-tax) in your local currency.*

2) Do you have other sources of income? (Partner income, parental support, spousal support, dividends, child support, etc.) If yes, please itemize that here for the past two years.*

3) Are you currently employed? If yes, what is your line of work? If no, please elaborate on your situation, including when/where you were last employed. If you are currently a student, please elaborate (school, degree path, etc).*

4) Do you receive SSI, SNAP, WIC, TANF, Medicaid, Unemployment, or any other form of social safety net benefits? If yes, please elaborate, including duration of benefits to date.*

5) Do you have children or other dependents? Please elaborate.*

6) How many vacations did you take in the last two years? Vacations do not include travel funded by an employer.*

7) Please list and describe any personal assets, including any home/land you own, stocks, savings accounts, etc.*

8) Do you have any special or extenuating circumstances I should know about in considering your request for reduced fee services?*

Would you like to join our email newsletter?*

Yes, thank you

Not today

Thank you for answering these questions. I know that it is sensitive to talk about money in our culture. Sharing this information is the start of our conversation about the appropriate fee for our work together.