Head Injury Association
65 Austin Boulevard, Commack, New York 11725
(631) 543-2245
Dear Applicant
Thank you for your interest in the Head Injury Association. For your convenience, we have created an online intake form. Following the completion of your online intake you will receive a follow-up call from the Head Injury Association's Family Support Services Department to discuss your specific needs and interests. Please note that in order for your application to be processed, we may request additional information including but not limited to the following: Head Injury Application or Universal Application Signed “Release of Information form, Medical form to be completed by physician, Psychological or Neuropsychological evaluation, Psycho social evaluation, Individual Service Plan (if applicable), Notice of Decision for OMRDD or DOH services (if applicable).
We may also request any additional information that will accurately reflect the applicant's needs (i.e., psychiatric summaries, behavior plans, etc.) Applicants interested in receiving ongoing services from the Head Injury Association may also be contacted to set up a screening after all requested information has been received. If you have any questions, please do not hesitate to call for more information. You can also get in touch with me by calling (631) 543-2245, ext. 268. Thank you.
Sincerely,
Michele Magro
Family Support Services
