top of page

Request A Free Pediatric Belt Cane

Join a project and obtain a free standard pediatric belt cane

Photos of kids with Safe Toddles Belt Cane

We are dedicated to provide a free belt cane to as many children as possible. Free belt canes are available to children who become a valuable part of one of our research studies. All belt cane users given access to our curriculum. 

CONTACT INFORMATION

 

arrow&v
arrow&v
PREFERRED METHOD OF CONTACT
arrow&v
PHOTO / VIDEO RELEASE. CHECK ALL THAT APPLY

SHIPPING ADDRESS

arrow&v
SHIPPING PREFERENCE

CHILD'S INFORMATION

CHILD'S MEASUREMENTS

VIEW STANDARD SIZE CHART
arrow&v
arrow&v
arrow&v
arrow&v
arrow&v
arrow&v
arrow&v
arrow&v
arrow&v
Does child receive any of the following services:
arrow&v
If yes, where have the mobility devices been used?
Complete all fields to Submit the form, including uploading Consent Form for the study you have selected.

Thanks for your order!