Contact — Adaptletics Rehabilitation & Conditioning for Neurologic Injuries

Manual Therapy IN the Neurologic Population

Course Pricing: $600

Email: cmcarroll@adaptletics.com

Phone Number:(973) 440-9257

Name

First Name

Last Name

Phone

(###)

###

####

Please list your professional title (ex. Physical Therapist)

Registering as Part of UNC Health System: Yes or No

cmcarroll@adaptletics.com
(973) 440-9257

Name

First Name

Last Name

What is your injury?

How much help do you need to transfer?

Are you currently receiving therapy elsewhere? If, so where?

What equipment did you require in past therapy sessions, if applicable?

What medications are you taking?

Please share falls history, if applicable.

Do you have skin integrity concerns?

Yes

Any additional information you feel is pertinent to your care.