Relationship to Person w/disability
If Professional: Field/Services Provided
If Professional/Business Name
Home AddressBusiness Address
If Family Member, Name of Person w/disability
Type of Disability
Person w/Disability Date of Birth mm/dd/yy
Person w/disability Gender
Request: Please check all that apply
Add to Mailing List
FashionABLE Model (school aged child)
Change of Address
New Parent Information
Lending Closet Request
Scholarship Info (Spina Bifida Individuals only)
Who we are
Spina Bifida Texas is the only organization solely committed to serving individuals affected by Spina Bifida in Central & South Texas.
"To improve the lives of those affected by Spina Bifida and to promote it's prevention through Folic Acid awareness."
Did you take your folic acid today?
Spina Bifida Texas
1550 NE Loop 410, Suite 224
San Antonio, TX 78209
©2004-2012. Spina Bifida Texas. All Rights Reserved.
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Connection to SBTX*
If other explain (example: aunt, physical therapist, etc.)
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