United Spinal Membership Form
Individual membership is free and open to people with spinal cord injuries or disorders, family members, care providers and professionals, and interested individuals.

Age Restrictions
You must be 18 years or older to qualify for membership in United Spinal. Parents and guardians of children under 18 years of age are encouraged to become members by completing the application. Please enter your information and not information pertaining to your child.

Consider joining a United Spinal Chapter! Please review our Chapter Directory for information on locations and services. There is no cost or commitment and no additional information is required. Click to view Chapter Directory

This form will enroll you as a member of United Spinal Association and subscribe you to New Mobility Magazine, our Member Magazine. You will also have an opportunity to join a chapter.
  • Contact Information

  • Please use your personal email if you have one. Your employer's policy may forbid receiving personal emails in the workplace.
  • Example: 134 Hillside Avenue
  • Enter apartment# or suite# or facility name
  • - -
  • About You

  • Enter the year of your birth. YOU MUST BE AT LEAST 18 YEARS OLD TO BECOME A MEMBER.
  • About Your Disability

  • Select all that apply.
  • I am a?
  • Enter Year, i.e., 1999
  • Select as many as apply.
  • Select all types of wheelchairs that you use.
  • Did you receive inpatient rehabilitation after injury or diagnosis?
  • Other

    Chapters are listed by state and city location for your convenience. Please be advised that most chapters serve an area much greater than the indicated area.
  • United Spinal has over 45 chapters offering local resources, events and support. Please choose a chapter near you to learn more and get connected with what is happening in your local area. There is no cost or commitment and no additional information is required.
  • *Enrolling you in a chapter requires that we forward your information to the chapter you selected. Your information will not be shared for any other purpose.
  • I would like to be contacted in regard to questions I have related to Spinal Cord Injury/Disease or United Spinal.
  • Would you like us to send you information on Affiliated Peer Support Groups near you?
  • FREE New Mobility Magazine Subscription

    Please select your free one year member subscription. New Mobility in print will be mailed to USA addresses only. Please allow 2 weeks for processing of membership and your free subscription.
  • Enter if you selected "Other" from above list.