Client Means Check Please complete the following in order to ascertain that the client is eligible for our therapy. Client FULL Name(required) Name of Assessor(required) Date of Assessment(required) Please tick those that apply [client must satisfy one of these to receive our therapy](required) Client does not work more than 10 hours per week The above applied and the client is in receipt of job seekers allowance and income support The client has been deemed by the Directorate as FNF and therefore is fee remitted. This client has been deemed unable to pay and evidence has been sought for this. What benefit is the client claiming, income support or job seekers allowance? Outcome(required) Client has been checked and they are on a limited or low income and therapy CAN proceed at a rate of £1 per session for 10 sessions They are deemed to be NOT on a limited or zero income. Client is unable to pay and this has been evidenced Client is FNF and does not need to pay If client is not paying at all, enter the rationale why here, including what evidence you have sought to provide this. If they are FNF enter the name of the Director who has deemed them as such here. If not applicable, enter N/A(required) If they are not benefits or a low income and still want counselling, please click here to be re-directed to one of our fee paying partners who can arrange to provide therapy to you at a reasonable capped rate. IF THEY HAVE PASSED THIS MEANS TEST, YOU CAN NOW GO AHEAD AND TAKE THEIR PAYMENT SUBMIT Δ
