Together We Thrive
The Brain Injury Association of Ohio and The University of Akron are hosting a workshop for brain injury survivors and caregivers focusing on improving communication and your relationship. November 15, 2025- 9:00 am - 3:00 pm - Cleveland Clinic Akron General Health and Wellness Center,Green - 1946 Town Park Blvd., Uniontown, Ohio This event is for adults (18 years old or older) who have sustained a brain injury and their care partner. Space is limited and spots will be filled on a first come, first serve basis. *Application will close November 5, 2025
Requirements to Participate:
- Individual with brain injury must be 18 years or older. -You MUST have a care partner that can attend the entire program both days with you. -You must be able to travel to the event location both days.
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you live alone?
*
Please Select
Yes
No
Phone Number
*
Please enter a valid phone number.
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Nonbinary
Prefer not to answer
Primary Language
Highest Level of Education you completed
Please Select
Some High School
High School
Some College
College
Graduate Degree
Are there any religious or cultural beliefs that impact your care that we need to be aware of?
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Do you have a caregiver that can attend with you both days?
*
Yes
No
Caregiver's Name
First Name
Last Name
What is your caregiver's relationship to you?
Caregiver's Email
example@example.com
Caregiver's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Caregiver's Phone Number
Please enter a valid phone number.
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Next
When was the date of your Brain Injury
*
-
Month
-
Day
Year
Date
How did you obtain your brain injury?
*
Do you have any food allergies or restrictions?
*
Are you on any special diet? (Feeding tube, pureed foods etc)
Do you have any non food allergies?
Do you have any accomodation needs?
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Next
What are your goals of participating in this program?
*
Submit
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