Financial Aid Application
Welcome! I'm so happy that you are ready to continue your journey to overcome codependency and chronic illness.

I I recognize that your individual circumstances are unique, which is I invite you to be open about your financial situation as we contemplate working together.

For those who are living on a limited budget or receiving a fixed income (such as Social Security Disability Insurance), I offer sliding scale fees and payment plans.

Please fill out the form below to apply and I will contact you within 24 hours with more details. All information you submit is confidential and stored securely, according to my privacy policy.

Katherine Housh, RN, HWN-BC

Email address *
Name *
Your answer
Are you currently employed? *
Are you a full-time volunteer? *
Do you receive Social Security Disability Insurance? *
What is your total monthly household income *
How many dependents do you have? *
Your answer
Do you receive any additional sources of income, such as alimony, child support, or contributions from your parents? *
How much are you willing to budget for health coaching every month, even if it means making sacrifices in other areas of spending temporarily? *
Your answer
A copy of your responses will be emailed to the address you provided.
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