Brain Injury Basics Northern Colorado

Brain Injury Basics is designed for adults living with a brain injury. This interactive workshop will cover:

Refreshments will be provided.

Date:
Tuesday, March 26, 2019

Time:
10:00am – 12:00pm

Location:
Carbon Valley Regional Library
Small Meeting Room
7 Park Ave
Firestone, CO 80504

Please select the workshop that you will attend:*
Registrations are taken as first-come-first-served. Maximum 12 participants. If you register for a workshop, you are committing to attend. This workshop will be held at the Carbon Valley Regional Library, 7 Park Ave, Firestone, CO 80504.
- Tuesday, March 26th, 10:00am - 12:00pm (10 spots left)
First Name*
Last Name*
Date Of Birth*
Mailing Address*
Street Address City State ZIP Code
County
Phone*
Email
I am a ...*
- survivor of brain injury
- caregiver or family member of a survivor
- professional
How did you hear about Brain Injury Basics?*
How did you hear about this class (Other)?
Is there anything else that we need to know or you would like to tell us?
Waiver*
- I have read, understand, and agree to this waiver.
Comments
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