Persons interested in participating in the Walk On program, please be aware of the following process. Call Walk On at 847-381-4231, state your interest. Be prepared to provide:
- Your name, address, and telephone number
- Pertinent information regarding the potential rider, including diagnosis, special needs, available days and times.
- Secure a referral from your physician for an Occupational Therapy evaluation to be brought at the time of the initial evaluation.
- Your name will be placed on the Waiting List.
- You will be notified when a vacancy becomes available which matches your availability.
- You will need to complete the following forms from the web site:
- Authorization for Emergency Medical Treatment Form
- Health History
- Release Form
- Participant Liability Release
- Non-Disclosure and Confidentiality Agreement
- Participant's Medical History & Physician's Statement
- Letter to Physician
- Physician's Referral
- Copy the Participant/Parent Handbook
- Review and become familiar with the rules and guidelines
- Be sure to check and sign the Participant Handbook Checklist on page 4 of the Registration packet
- You will be contacted to have an initial assessment to determine your eligibility for the program, be sure to bring the Physician's Referral to this assessment.
|Participant Registration Packet|
|Participant Medical History & Physician's Statement|
|Participant Physician Referral|
For more Information
Call Us:Office: (847) 381-4231
Barn: (847) 842-8349
Fax: (847) 381-4288
Visit Us At:Walk On
26665 W Cuba
Barrington IL 60010
Mailing Address:Walk On
P.O. Box 376
Barrington, IL 60011-0376