How to Apply

Application and Required Forms
Prior to your initial evaluation, your application and physician’s clearance must be sent to Push to Walk either by fax (201-644-7568) or email kwolfe@pushtowalknj.org

Potential clients please review and complete one of the forms below.

**All clients must be independent of a ventilator.**

Client Responsibilities
Clients must be able to maintain their appointments on a consistent basis, have reliable transportation and the financial ability to pay the hourly fee of $105. Scholarship funds are available to individuals who qualify.

Still not sure if you’re a candidate?

Please complete the form below, and a Push to Walk team member will get back to you.