Consideration for Sliding Scale
Use this form if you would like to be considered for 45 minute sliding scale (online) sessions
Name ( First and Last) *
email ( **please** check as one wrong letter means I cannot reply to you) *
Location - city / country *
Sessions Type *
My practice is specific and unique. Why have you chosen me to work with? *
What would you like to work on with me? Just a general description is enough. *
Describe the current financial and employment situation for the people seeking sessions including why you'd like to be considered for fee reduction. *
Sliding scale sessions are offered online only Mon-Thurs 10am-3pm (Eastern) each week. Nominate the fee you can afford to pay for weekly online sessions. *
Are you able to commit to weekly, daytime, online sessions for at least several months? If not, I won't be able to accommodate you. *
Please indicate your affiliation with any of these communities/ identities/practices *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy