NEW CLIENTS: Forms Available Below
All clients must complete the following paperwork before being scheduled for an initial evaluation for the Mobility Program
- Client Information Form
- Medical Release
- Client Waiver
- Media Release
- Payment Form
Scholarship applications are available for individuals in need.
Please scan and email a digital copy of the paperwork to Info@bridgingbionics.org and bring the original copies with you to your first scheduled session.
Our Mobility Program is a charitable outreach to encourage locals with mobility impairments living in the Roaring Fork Valley and I-70 corridor to attain a better quality of life. Bridging Bionics Foundation conducts ongoing fundraising activities to sustain the program and offset the cost for physical therapists, training and compensation.
- One-Year Annual Program Fee
A one-time annual minimum program fee of $500 to participate in the program is recommended. (Sponsorship applications are available upon request.)
- One-time Visit Only
For individuals who use the technology for one time only, the recommended donation is $150.
Please make your check payable and send to:
Bridging Bionics Foundation
PO Box 3766
Basalt, CO 81621
We appreciate a 48-hour cancellation notice from your scheduled appointment.
If you need to cancel within a 24-hour period before your scheduled appointment, we encourage a $75 donation per scheduled hour to cover the cost of compensating our physical therapists for their time.
FOR MORE INFORMATION