Apply for a Go Baby Go! car in Milwaukee

Who may qualify for a car?

  • A child between 9 months and 5 years of age who has difficulty independently moving through space.
  • Diagnoses may include: Cerebral Palsy, Spina Bifida, Genetic Syndromes, Down Syndrome, Congenital Heart Defect, Prematurity, Autism, and other neurologic or orthopedic conditions.
  • It is ideal for the child to have sufficient head control and to be at least working toward independent sitting.
  • If the child has seizures, it is ideal that the seizures are well-controlled.

What is the commitment asked of the family?

  • Complete the family application
  • Attend a 30-minute fitting with your child at a designated Marquette University or Children's Wisconsin location.
  • Pick up the car from Marquette University approximately 4 weeks after the initial fitting. Your child does not have to be present for the pick-up.
  • Very safely and closely accompany your child as the car is utilized in a controlled environment.

If you are unable to come to your scheduled fitting appointment, it is your responsibility to email gobabygomilwaukee@childrenswi.org to reschedule well before your child’s appointment day. A missed appointment is when you either do not show up or you call to cancel an hour or less before the appointment.

  • If you miss your fitting appointment 1 time, it is your responsibility to contact Go Baby Go! Milwaukee to reschedule your fitting; however, your child will go to the end of the waitlist due to the influx of applications.
  • If you miss your fitting appointment 2 times, Go Baby Go! Milwaukee has the right to discontinue your application

What benefits might you expect from your child using a car?

  • Increased opportunities for language and socialization
  • Improved exploration of the environment
  • Increased qualify of life and well-being for the child
  • Reduced caregiver burden
  • Increased sense of independence and initiation skills
  • Improvement in motor and cognitive skills
  • Improved participation in play with siblings/peers

Do you have a child that needs a car?

Fill out the form below and one of our therapists will be in touch with you within two weeks. 

 

Demographics

Current rehabilitation services

Home environment

Child’s characteristics and abilities

I authorize Children’s Wisconsin (“Children’s”) to disclose this form, and to discuss my child’s medical information, to/with Marquette University (“Marquette”) for consideration of my child’s participation in the Go Baby Go program. If my child meets the criteria for the program, a therapist and Marquette will further evaluate and fit my child for a motorized car modified by Marquette. I understand the following:

• I may revoke this authorization by sending written notice to gobabygomilwaukee@childrenswi.org.

• My child may not be able to participate in the Go Baby Go! program if this authorization is revoked.

• The failure to sign this authorization or to participate in the Go Baby Go! program will not impact my child’s treatment, payment or participation in other Children’s programs.

• Children’s is not responsible for the further disclosure of my child’s medical information by Marquette or any subsequent recipients of my child’s medical information.

• This authorization is valid for one year, or until my child’s participation in this program ends, whichever occurs sooner.

I have read this information. I am legally able to consent for my child. By signing this form, I give my permission and agree to the terms listed above.
Contact us

If you have questions about the Go Baby Go! program, please email:

Milwaukee: gobabygomilwaukee@childrenswi.org

Fox Valley: gobabygofoxvalley@childrenswi.org