How to Apply

Application and Required Forms
Prior to your initial evaluation, your application, physician’s clearance, and bone density test report 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.


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