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Sliding Fee Scale Discount Program
At Norkris Services, our mission is to provide high-quality, patient-centered mental health care to all individuals, regardless of insurance status or ability to pay. To support this commitment, we offer a Sliding Fee Scale (SFS) Discount Program.
The Sliding Fee Scale Program allows eligible patients to receive services at a reduced cost based on household income and household size, using current Federal Poverty Guidelines. Eligibility is determined regardless of insurance coverage.
How to Apply
Step 1: Complete the Application
Download and complete the Sliding Fee Scale Discount Program Application.
Step 2: Submit Proof of Income
To determine eligibility, please submit your completed application along with documentation verifying your household income and household size. Income documentation must be submitted within two (2) weeks of your application. Applications without supporting documentation after two weeks will be considered incomplete and may be denied. A new application will then be required.
Please provide two (2) of the following forms of income verification:
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Most recent pay stub
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W-2 formMost recent federal income tax return
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Written statement from employer
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Unemployment benefits statement or check stub
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Social Security benefits statement or check stub
If you are unable to provide proof of income, please contact our office to discuss completing a self-declaration of income form.
Step 3: Submit Your Application
Completed applications and supporting documentation may be submitted in person or mailed to:
Norkris Services
Attn: Sliding Fee Scale Program
611 South Union Avenue
Havre de Grace, MD 21078
Application Review Process
Please allow up to 30 days from the date your completed application is received for review and processing. You will receive written notification of your approval or denial. If approved, you must contact the Norkris office within two (2) weeks of receiving your approval notice to confirm your acceptance of the Sliding Fee Scale Program.
Renewal Requirements
Participation in the Sliding Fee Scale Program must be renewed every 12 months. Patients are also required to submit a new application whenever there is a significant change in household income or household size.
Important Notice
Providing false, misleading, or incomplete information on a Sliding Fee Scale Discount Program Application may result in:
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Immediate termination of program benefits
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Revocation of discounted fees
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Restoration of the full account balance
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Immediate responsibility for all outstanding charges
Questions?
If you have questions about the Sliding Fee Scale Discount Program or need assistance completing your application, please contact our office. A member of the Norkris team will be happy to assist you.