Sliding Fee Scale Discount Program

Community Clinical Services is a Community Health Center providing care to all patients who seek our services regardless of insurance or financial status. No patient is ever denied care due to an inability to pay. We offer a Sliding Fee Discount to patients with income at or below 200% Federal Poverty Levels, set forth by the most recently published HHS Federal Poverty Guidelines: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines

To qualify, please ask for an application at your next visit or download one from the links below. Applications are available in our patient population’s top languages, including:

Once completed, your application and proof of income will be reviewed by one of our financial counselors to determine eligibility. Once approved, your sliding fee discount will be applied retroactively to any unpaid services that occurred within 240 days of your approval, as well as 12 months after your approval date. After 12 months, you will need to complete another application to re-assess eligibility.

Click the image to download our 2026 Sliding Fee Scale

Annual FQHC Demographic & Income Verification Form Information:

We ask all of our patients to complete (and update annually) a quick, one page form that asks information about demographics such as your housing status, transportation needs, veteran status, and income information. All Federally Qualified Health Centers collect this information, which is utilized (anonymously) to make informed adjustments to our programming to best meet the needs of our patient population. We ask for your household size and estimated income to determine how many of our patients are eligible for our Sliding Fee Discount.

Click here to view and download a copy: 2026 Annual FQHC Form

To receive this form in another language, please visit our B-Street Health Center and ask a staff member to assist you.