Eligibility Requirements

Sliding Fee Scale Requirements

You are required to bring the following to your eligibility appointment:

  1. Proof of address - Documentation such as a receipt for rent, mortgage, lease, Arizona Driver’s License or utility bill (electricity, water).
  2. Proof of Identification – Picture identification such as an Arizona Identification Card, Driver’s License or U.S. Passport.
  3. Proof of Income - Documentation of source of income for a one month period, (paycheck receipts, social security documents, unemployment receipt or pension).
  4. Dependent Information – (Birth date, Social Security number).

Sliding Fee Scale(PDF, 148KB)

Back to top