UIRC Sliding Fee Scale Application
We know that family building is expensive. We want individuals managing infertility to have access to affordable mental health counseling. Please apply if you feel you would benefit from reduced cost sessions. Reduced and sliding fee scale sessions are limited to 8 per client in order to accommodate the many who are also struggling with the mental and emotional impact of infertility. Extensions are approved on a case-by-case basis by the UIRC Clinical Committee.
Name *
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Date of Birth *
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Total yearly household income from all sources. *
Number of people in household. *
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Please describe any extenuating circumstances. (Temporary job less, illness) *
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