Check eligibility for financial aid
If you are facing financial challenges, you may be eligible for discounted therapy costs
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3. How much do you and your spouse (combined) earn from working on a monthly basis? (Please include gross wages, salaries, income from business, tips, etc.)
4. Please enter the monthly income of you and your spouse (combined) from the following sources (enter "0" where not applicable):
Social security (including SSI):
Support / Alimony:
Public assistance or veteran's payments:
Pension or retirement income:
Interest, dividends, rents, other income:
7. How many children do you have who receive more than half of their support from you? (enter "0" if none)
8. How many dependents (other than your children or spouse) live with you and receive more than half of their support from you? (enter "0" if none)
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