Sliding Scale Form for Therapy Sessions 
Greetings,

Sliding scale is often provided to make therapy services accessible to as many clients as possible. We at Karma Care recognize that people from certain marginalized groups (For e.g. people from the LGBTQIA+ community, women, people with disability, people from caste/class minorities etc.) cannot easily access therapy and are thus offering a sliding scale.

Kindly fill the following form if you wish to be on the waitlist to avail sliding scale for sessions with the psychologists at Karma Care. We shall reach out to you as soon as a slot opens up!
Email *
Who would you like to book a session with? *
Name *
Phone Number *
Email ID *
Geographical location *
What makes you want to access the sliding scale? *
Do you belong to any group/community that may be marginalized (with respect to caste, class, sexuality etc.)?  *
Are you finding it difficult to afford mental health services due to your social positioning?
Are you a student? *
How much are you willing to pay per session? *
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