The Sliding Fee Scale may give you a discount on services at LifeWays.

A completed Sliding Fee Scale Application is a requirement of the Michigan Mental Health Code at admission and must be completed annually and/or if income or insurance changes.

All information provided will be kept confidential.

Complete Sliding Fee Scale Application.

Sign the Sliding Fee Scale Application.

Upload proof of ALL income for ALL household members over the age of 18.*

You must provide one of the following documents for proof of household income:

• Most current Federal Income Tax Return(s)

• Most recent W-2's

• One month of most recent household pay-stubs

• Award letters from Social Security, pensions, annuities, trust funds (if applicable), and/or one month of most current Unemployment statements or check stubs

If you cannot provide one of the above, please include the last 3 months bank statements showing income received.

*If you are married, you must provide yours and your spouse’s proof of income.

Submit your application and all supporting income documentation by using this online form.

Paper applications are available by request at the front desk.

You can also download a PDF application and mail it with your supporting documentation to 1200 N. West Ave., Jackson MI 49202 by clicking here.