Low Cost Therapy Application

Please use this application to provide details that will help our selection committee determine your needs and whether or not you qualify for low-cost therapy. Not everyone will qualify, but if you do, we will reach out when our application begins in September and January. Be as thorough as you can. Please note “I do not have money” will not pre-qualify you for our program.

Please proved the below relevant information for our selection committee to help determine your need.

We would love to chat with you. How can we get in touch?

Please describe in detail what you are looking to achieve in therapy.