Permission Form

Permission Form to Allow Specialized Care Co. to Sell a Protective Stabilization Product Directly to a Parent or Caregiver

Specialized Care Company normally will sell “protective stabilization” products to medical or dental professionals. If you, as a professional, would like your patient to be able to purchase one of the following products directly from us, please click here to download and complete the permission form. Email the completed form to

• Rainbow® Stabilizing Wraps, Boards or Safety Belts

• Rainbow® Elbow and Knee Stabilizers

Thank you for your concern for your patient’s special needs and thank you for referring your patient to us.




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