AMK Sliding Fee Scale Spanish
NOTE: To comply with federal
regulations, in order to give you
a discount on our therapeutic
services, it is necessary for us to
ask some personal questions.
Your answers will be kept on file
and in strict confidence. You
must verify your income at least
every year. Please bring yearly
income tax return, copy of your
W‐2 form, last month’s paycheck
stubs, copies of your social
security checks, or other checks
you may receive as proof of
family income.
Only the family size and annual
income will be used to
determine your eligibility and
calculate your discount.