New Clients

To make an appointment at any of our clinic locations:
Call 800.657.5177.

Options Clinic staff will ask you:

• Your first and last name
• Your date of birth
• A phone number where you can be reached
• If we may identify ourselves as Options Clinic, if we need to contact you
• And if you would like a reminder call prior to your appointment.

To apply for a WAIVER program you will need:

• Bring a picture ID,
• A month's worth of your most recent pay stubs,
• And if you were not born in Wisconsin, you will need a birth certificate or passport.

Income Assessed Sliding Fee Discounts for Services and Supplies

Level 1	100% discount
Level 2	75% discount
Level 3	50% discount
Level 4	25% discount
Level 5	0% discount

You will be given a client number on a card at the time of your appointment.
This client card and number are important for any future communication with Options Clinic staff.
KEEP THIS NUMBER SAFE.

Documents:
Demographics Form
Employer Verification of Earnings