At Tia, we are committed to making quality women’s healthcare more accessible to all women, and believe that the cost of the membership at Tia should not be a barrier to quality women’s care. We understand that a membership fee can be cost prohibitive for some, and do waive membership fees for those that qualify for a low income waiver or due to financial hardship.  Tia uses the NYC housing department's definition of "Area Median Income" (AMI) as the qualifier for "low-income." What this means is that any woman whose income falls under the median income is eligible to apply for a waived Tia membership fee. We will also always take into account an individual’s circumstances. 

If you would like to apply for a free Tia membership, please complete this form and send the following documents to

  • A recent Tax Return
  • A recent W2 or 1099
  • A current pay-stub

Once we have received this information, we will get back to you within 48 hours. If approved, we will waive your yearly membership fee ($150), but you will be responsible for any patient responsibility for services you get at the Tia Clinic, according to your insurance plan (e.g. co-pays, coinsurance, etc). 

Please note, this membership will be granted for one year. You will need to re-apply for a waived membership every year.

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