Financial Assistance

 

How to Apply for Financial Assistance (for current patients only):

The PAG determines whether patients may qualify for financial assistance. The primary criteria is that the situation is an unexpected one.

To apply for financial assistance download the “criteria” form , follow the instructions, and write a description of your situation and add all supporting documentation necessary. Next download the consent form and sign it so that we may release your information to the PAG for consideration of assistance. Bring both forms and supporting documentation into the clinic and it will be submitted to the PAG. The PAG usually meets on Thursdays. You will be notified of their decision no later than Friday.

Patient Advocacy Group
This group is autonomous of the clinic but is allowed to use the clinic premises and resources. The PAG advocates for patients, educates patients, puts out a newsletter, helps patients having financial difficulties with their fees, holds fund raising events, serves as a grievance committee, and is continuously growing and adding new members. Our clinic donates a specific amount of money each year to the PAG and matches monies gathered through PAG fund raising events.

Patients needing assistance with their fees may read about criteria for assistance here, and complete and sign a consent here, to take into the clinic and submit to the PAG.

 

PAG CONSENT

 

PAG CRITERIA