Application
StRides Against Suicide & Overdose Scholarship Application
The StRides Against Suicide & Overdose Scholarship Program is dedicated to helping individuals in Northwest Indiana access vital counseling services for suicide prevention and overdose recovery. If you or someone you know is in need of support, this scholarship may provide the financial assistance necessary to attend therapy sessions.
To apply for the scholarship, please complete the application form below and submit it with the required documentation. Clients must reside in Northwest Indiana as defined by the Mission Statement of StRides Against Suicide & Overdose.
Required Documentation:
W-2 or Two most recent paystubs
Proof of Insurance or Denial Letter for Insurance Coverage
Please be aware of the following scholarship guidelines:
This scholarship can only be applied for and received once per calendar year.
Future scholarships may not be granted depending on available funds and demand.
If you cancel or miss two scheduled appointments, you will forfeit the remainder of your scholarship.
Clients must pay any applicable co-pays at the time of each appointment. Failure to do so may result in the forfeiture of the scholarship.
How to Apply:
Complete the application form below.
Submit the completed form, along with your required documents, to Fax: 21-728-1860 or Email: admin@lpacounseling.com.
Important Notes:
Scholarship recipients are not guaranteed continued therapy beyond the approved sessions. After your sessions are completed, you may be referred to another counseling provider for further treatment.
If you attend therapy sessions beyond the approved scholarship amount, you will be fully responsible for the cost of those additional sessions.
Please ensure that all areas of the application are filled out completely and accurately to avoid delays in processing.
Click the icon below to download the attached PDF.
