You may be eligible for discounted service. Discounted services are based on verified family size and household income. To see if you qualify for discounted services, you will need to provide proof of income for each member of your household over 18 years of age.
Proof of income is:
• Prior W-2
• Prior year tax return
• Last 2 check stubs
• Unemployment, social security, disability determination letter, letter on letterhead from your employer or notarized statement declaring your income
• Self employment income (tax return)
Without this information, you are expected to make full payment at the time of service. Please call our office at (513) 588-3623 to set up an appointment to see if you qualify for discounted services.
You may print and fill out the Financial Assistance forms located under the Patient Forms section and bring them with you to your appointment. You will also need to bring the following items to your Financial Assistance appointment:
• Proof of income
• Photo ID or birth certificate for all related household members