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BIA OF KANSAS

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Our thanks to our valued Corporate Members:  
Ability KC

Alliance Home Health Care

Copley Roth & Davies, LLC

Kansas City Vision Performance Center

Kansas Rehabilitation Hospital

Madonna Rehabilitation Hospital

Meadowbrook Rehabilitation Hospital

Menorah Medical Center

Mid America Rehabilitation Hospital

Minds Matter

NeuroRestorative

North Kansas City Hospital

OCCK Inc.

Pate Rehabilitation

Rehabilitation Hospital of Overland Park

Saint Lukes Marion Bloch Neuroscience Institute

Select Specialty Hospital Kansas City

Therapy Services

The Dream Works





BIAA HOME : CONFERENCE REGISTRATION : KANSAS : PREVENTION : HELMET DONATION REQUEST

Helmet Donation Request Form

* Required














Sizes needed:












Ethnicity of helmet recipients: (This section is not required; however this information is frequently requested by foundations that provide the funds for purchasing these helmets)






Age of helmet recipients: (This section is not required; however this information is frequently requested by foundations that provide the funds for purchasing these helmets)






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