Stroke and Brain Injury Services


Stroke and Brain Injury Services – Medical Release Form


Should an accident or illness occur, it may be necessary to provide for local emergency medical service for clients participating in any therapy services at AbilityPath Brain Injury Rehabilitation Services. Please indicate your permission for such treatment by completing and signing the form below.

In case of emergency, AbilityPath Brain Injury Rehabilitation Services is authorized to call 911 for emergency services. If it should be necessary for an ambulance to be obtained, I will assume payment of such a bill.

Physician Information

In case of an emergency, please contact:

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