Complimentary Membership for Patients of Rehabilitation Hospitals

In order for the Brain Injury Association of NC to make a connection with persons with brain injuries who are discharged from your hospital, we need your assistance with obtaining information.

Please ask each person diagnosed with brain injury to consider a complimentary membership with the Brain Injury Association of NC.  This will allow us to send information to them about brain injury and follow up with them periodically to make sure they are receiving resource information, education & training, information about support groups, etc.

Please complete the electronic form below.

You may also print the Complimentary Form by clicking the button below and downloading it. If you choose to print the form, you can send it to the address listed at the bottom or take a clear photo and email it to

Thank you for your assistance!