Downloads

Private Pay clients must bring a valid proof of ID, such as a Driver’s License or State ID. If sliding scale payment are being requested you must bring the completed Financial Statement Form to be considered. 

Potential Access to Recovery (ATR) clients must bring valid proof of ID, Social Security Card, and a notarized copy of the Fee Determination Form.

Please click on the appropriate link below, print, and return the forms to ACER.

Fee Determination Form
Financial Statement Form