Application for Sliding ScalePlease complete the following information for sliding scale information. Name * First Name Last Name Email * Phone (###) ### #### Which services are you interested in receiving from ACE Speech Therapy, LLC.? Assessment/Evaluation Services Therapy Services Parent Coaching What is your household income? * Please select your household income within the dropdown options: Less than $30,000 $30,000-$44,999 $45,000-$59,999 $60,000-$74,999 $75,000-$89,999 $90,000 and up Message * Thank you for submitting your contact and income information. Hannah will reach out to you with sliding scale prices shortly.