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Clinical Services Subsidy Request

Questions marked with a * are required

Eating Disorders Nova Scotia is pleased to be offering subsidies to make working with a clinical provider more accessible.

To request a subsidy, please complete this form. We will review your request and will be in touch.

Contact Information

First Name

Last Name

Phone

Email Address

City and Province

Postal Code

Subsidies last for six sessions, how many times have you applied?

First Time

Second Time

Third Time

How did you hear about our clinical services?

Have you taken part in other supports offered through Eating Disorders Nova Scotia?

Yes - Online Chat

Yes - Mentoring

Yes - Virtual Workshop

Yes - Peer Support Group

Yes - Nutrition Counselling

Yes - Therapy

Yes -Trans Peer Support Group

Yes - Recreational Therapy

No

Do you have any existing coverage for these services? (Like Blue Cross, Medavie, Great West Life etc)

Yes

No

This subsidy is only available for those without coverage, has your coverage run out? If it has, when does it renew?

I am requesting a subsidy for the:

Nutritional Counselling

Therapy

I am interested in seeing a Dietitian. I understand the cost for the initial session is $130, and follow up sessions are $110. I am able to pay:

75% or $97.50 for the initial session, $82.50 for regular sessions

50% or $65 for the initial session; $55 for regular sessions

25% or $32.50 for the initial session; $27.50 or regular sessions

NA

I'm interested in seeing a Therapist (16+). I understand the cost for the initial session is $220, and follow up sessions are $180. I am able to pay:

75% or $165 for the initial session, $135 for regular sessions

50% or $110 for the initial session; $90 for regular sessions

25% or $55 for the initial session; $45 or regular sessions

NA

I am interested in seeing the Therapist (Child and Family). I understand the cost for the initial session is $220, and follow up sessions are $180. I am able to pay:

75% or $165 for the initial session, $135 for regular sessions

50% or $110 for the initial session; $90 for regular sessions

25% or $55 for the initial session; $45 or regular sessions

NA

I confirm that without a subsidy, I would not be able to access this service.

Yes

No

Is there anything else that you'd like to share?

If this service is still out of reach financially please contact us directly at clinical@eatingdisordersns.ca or at 902-809-8567.

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