If you don’t ACT NOW, people with significant disabilities, including:

• ALS
• Muscular Dystrophy
• Cerebral Palsy
• Spinal Cord Injury
• Brain Injury

Will not receive the funding they need . . .
to get the power wheelchair and accessories required
to lead productive, rewarding lives.

Instead, many will be stuck in their homes, in their beds or even in nursing homes.

SIGN the petition NOW
to tell Health and Human Services Secretary
Michael Leavitt that he must . . .

Delay implementation of the Medicare
Power Mobility Device Policy Change & Fee Schedule
Effective November 15, 2006

For more information, visit ComplexRehab.org

Petition Opposing Adoption of Medicare PMD Coverage Policy
and Fee Schedule, Effective November 15, 2006

As consumers of healthcare, we the undersigned, appeal to Secretary of Health and Human Services Michael Leavitt to delay for six months the implementation of a policy and fee schedule. This will drastically reduce the ability of people with severe disabilities such as ALS, muscular dystrophy, cerebral palsy, spinal cord injury and severe brain injury to receive the funding they need to secure the proper power wheelchair and accessories required to lead productive and rewarding lives that would otherwise limit their world to their homes, to their beds, or even worse, to nursing homes.

Signature:	Name:	Email:
______________________________	______________________________	______________________________

Please fax form back to: 1-877-582-1178