Patient Questionnaire

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Patient Questionnaire

2025 FEDERAL POVERTY LEVELS

Size of
Household
150%
monthly
150%
yearly
200%
monthly
200%
yearly
250%
monthly
250%
yearly
1 $1,956 $23,475 $2,608 $31,296 $3,260 $39,120
2 $2,644 $31,725 $3,525 $42,300 $4,407 $52,884
3 $3,331 $39,975 $4,442 $53,304 $5,552 $66,624
4 $4,019 $48,225 $5,358 $64,296 $6,697 $80,364
5 $4,706 $56,475 $6,275 $75,300 $7,845 $94,140
6 $5,394 $64,725 $7,192 $86,304 $8,990 $107,880
7 $6,081 $72,975 $8,108 $97,296 $10,135 $121,620
8 $6,769 $81,225 $9,025 $108,300 $11,282 $135,384