BIN Brain Injury Clubhouse Membership Application

Clubhouse Membership Application

There are no fees or costs for membership at Brain Injury Network clubhouses. Our services are free and funded through generous community support and donations. 
If you need assistance completing the application, please contact us at help@thebind.org 
If you prefer to contact us by phone, please call the Plano location at 972-769-2463 or the Fort Worth location at 682-255-7373.

Brain Injury Network Clubhouse Locations: 

Plano Clubhouse: 1416 Gables Court Plano, TX 75075
Fort Worth Clubhouse: 3601 NE Loop 820, Suite 140, Fort Worth, TX 76137

Membership Requirements:

All applicants must be 18 years of age or older, have a history of acquired brain injury, be independent with self-care, assistive devices, and medicaton, not be a threat to self or others, and willing to participate in the work-ordered day.

Thank you for your interest in becoming a clubhouse member!

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Contact Information
BIN Clubhouse Member Application Questions

Thank you for completing the membership application. Once you submit the form, our members will contact you to schedule a tour of the Clubhouse location you selected or the one closest to the address on your application.

To learn more about Brain Injury Network and our clubhouses, visit www.thebind.org or call 972-769-2463 (BIND Clubhouse in Plano) or 682-255-7373 (BINFW Clubhouse in Fort Worth.) 

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Brain Injury Network Privacy, Confidentiality & Data Storage
Confidentiality is defined as "the preservation of privileged medical, financial, demographic, situational or other personal information." Respecting the privacy of our members is a basic value of the organization. Because BIN receives funding from various local and state government agencies, collecting each member's confidential information is required. This information may include but is not limited to legal name, date of birth, address, verification of residency, race and ethnicity, gender, and employment status. In most cases, BIN will not be able to provide services to members without first collecting this demographic information. Further, BIND will not be able to provide services to members without receiving documentation that the member handbook has been received and understood and the member has provided additional consent. This process and the handbook will be explained by BIND staff during your orientation. In most cases, member information is reported to government agencies/billing sources in a way that 'de-identifies' the individual. This means that a member's name is not provided, and a unique 'member ID' is assigned instead, which does not include the member's first or last name. Without expiration, all employees, volunteers, student interns, and board of director members across all locations and situations will be required to follow confidentiality policies and procedures. A member's confidential information is accessible to all BIND staff and designated volunteers. This information will always be password-protected, including data stored on cloud-based systems or 3rd party platforms. In addition, all BIND staff and volunteers will participate in regular training regarding our confidentiality policies and procedures. In a medical emergency, your private information will be provided to emergency medical technicians at their request to ensure that you receive the most appropriate care. Unless otherwise specified in BIND policies and procedures, member records will be stored by the organization for 3 years following separation.
Don't hesitate to contact us (help@thebind.org) if you have any questions about our confidentiality policies and procedures.