Sliding Scale for Individuals $135 - $235

Please Answer the following questions thoughtfully with a “yes” or “no.” Do not hesitate to talk with me if you have questions or if you feel this questionnaire does not accurately reflect your financial situation.

1. Do you have savings more than $4000?

2. Do you have an income earning partner you share resources and expenses with?

3. Do you own a home?

4. Do you travel or go on trips regularly (at least once a year)?

5. Do you have kin you can ask for financial support?

If you answer “no” to all these questions you can place yourself anywhere on the scale that works for you. If you answer “yes” to one question, we will decide together. If you answer “yes” to two or more you will be in the middle of the scale. If you answer “yes” to 4 or more you will be expected to pay at the highest end of the scale.

Sliding Scale for Couples $175 - $250

Please Answer the following questions thoughtfully with a “yes” or “no.” Do not hesitate to talk with me if you have questions or if you feel this questionnaire does not accurately reflect your financial situation.

1. Do you have cumulatively have savings more than $5000?

2. Do you own a home, individually or together?

3. Do you travel or go on trips regularly (at least once a year)?

4. Do you have kin you can ask for financial support?

If you answer “no” to all these questions you can place yourself anywhere on the scale that works for you. If you answer “yes” to at least one question, we will decide together. If you answer “yes” to two or more you will be in the middle of the scale. If you answer “yes” to three or more you will be expected to pay at the highest end of the scale.