The Hope Foundation Provider's Form Logo

  • We're glad you're here!

    This form is for onboarding purposes only, to submit invoice for payment please visit: www.hopefoundationgives.org/therapist

  • Thank you for being part of HOPE! Please complete your session rate information.

  • We are happy you're here!

    Please complete the onboarding information.
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  • Session Information

    Our goal is to provide as many paid sessions as possible to our awardees. As a donor-based organization, funds are limited, and your cooperation is greatly appreciated!

  • $150 Session Cap

    Applicants who wish to work with providers whose rates exceed $150 per session may still apply for sponsorship under the following conditions: 1. the applicant agrees to personally cover the remaining balance of the session rate, or 2. The provider is able to offer a sliding scale that brings the session cost within our $150 limit.

  • We cannot continue.

    Unfortunately we cannot continue with your application, please select the button below to let us know you cannot accept this sponsorship.

  • ACH PAYMENT DETAILS

    For faster payment processing please provide banking details
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  • Please use this link to access the IRS website to fill out a new W-9 if you do not have one. 

    https://www.irs.gov/pub/irs-pdf/fw9.pdf

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