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Summary of financial assistance program

At Coastal Connecticut Counseling LLC (CCC) we pride ourselves on being able to provide affordable mental health services to clients who would otherwise not be able to get the support they need. If you are interested in receiving financial support, you will be asked to complete a financial assistance application and provide requested documents, to verify the amount of financial assistance available to you.

How do I apply for financial assistance?

To make applying for assistance easier, Coastal Connecticut Counseling LLC uses one application to apply for our Financial Assistance Program. To apply, complete the steps below.  

Complete the application

  1. Please complete all of the questions and sign and date the Financial Assistance application.    

  2. Attach proof of income to your Financial Assistance application. Proof of income is a document that shows your income at the time a client fills out the application. Examples include W2, recent pay stubs, or recent tax return.

  3. Mail or email the completed application​​

Please include: 

  1. Completed, signed, and dated application

  2. Proof of income

By email:

By mail:
Coastal Connecticut Counseling LLC
2690 Post Road, Southport, CT 06890

To learn more, to obtain a free copy of the Coastal Connecticut Counseling LLC Application for Financial Assistance, or if in need of help completing the application contact us at:

Phone: (203) 307-3030 M-F 8:00a - 5:00p


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