Document:

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                                                                     Exhibit 4.6

                           SELECT MEDICAL CORPORATION

                                  $175,000,000

                    7 1/2% Senior Subordinated Notes due 2013

                   EXCHANGE AND REGISTRATION RIGHTS AGREEMENT

                                                                 August 12, 2003

J.P. MORGAN SECURITIES INC.
MERRILL LYNCH, PIERCE, FENNER & Smith
         INCORPORATED
WACHOVIA CAPITAL MARKETS, LLC
SG COWEN SECURITIES CORPORATION
CIBC WORLD MARKETS CORP.
FLEET SECURITIES, INC.
JEFFERIES & COMPANY, INC.
c/o J.P. MORGAN SECURITIES INC.
270 Park Avenue, 4th floor
New York, New York  10017

Ladies and Gentlemen:

                  Select Medical Escrow, Inc., a Delaware corporation ("Select
Medical Escrow"), proposes to issue and sell to J.P. Morgan Securities Inc. ("JP
Morgan"), Merrill Lynch, Pierce, Fenner & Smith Incorporated, Wachovia Capital
Markets, LLC, SG Cowen Securities Corporation, CIBC World Markets Corp., Fleet
Securities, Inc. and Jefferies & Company, Inc. (collectively, together with
JPMorgan, the "Initial Purchasers"), upon the terms and subject to the
conditions set forth in a purchase agreement dated July 29, 2003 (the "Purchase
Agreement"), $175,000,000 aggregate principal amount of its 7 1/2% Senior
Subordinated Notes due 2013 (the "Securities") to be assumed by Select Medical
Corporation, a Delaware corporation (the "Company") upon the closing of the
Acquisition (defined below) and to be jointly and severally guaranteed on a
senior subordinated basis by the subsidiaries of the Company listed on Schedule
I and signatories hereto (the "Select Guarantors," and together with any
additional guarantors of the Securities after the date hereof, including,
without limitation, Kessler and its wholly-owned subsidiaries upon the closing
of the Acquisition, the "Guarantors"). Capitalized terms used but not defined
herein shall have the meanings given to such terms in the Purchase Agreement.

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                  The net proceeds of the issuance of the Securities will be
used in part to acquire (such acquisition, the "Acquisition") all of the
outstanding capital stock of Kessler Rehabilitation Corporation ("Kessler")
pursuant to a Stock Purchase Agreement, dated June 30, 2003 (the "Stock Purchase
Agreement") by and among the Company, Kessler and Henry H. Kessler Foundation,
Inc.

                  As an inducement to the Initial Purchasers to enter into the
Purchase Agreement and in satisfaction of a condition to the obligations of the
Initial Purchasers thereunder, the Company, Select Medical Escrow and the Select
Guarantors agree with the Initial Purchasers, for the benefit of the holders
(including the Initial Purchasers) of the Securities, the Exchange Securities
(as defined herein) and the Private Exchange Securities (as defined herein)
(collectively, the "Holders"), as follows:

                  1. Registered Exchange Offer. The Company and the Guarantors
shall (i) prepare and, not later than 45 days following the closing date of the
Acquisition (the "Acquisition Date"), file with the Commission a registration
statement (the "Exchange Offer Registration Statement") on an appropriate form
under the Securities Act with respect to a proposed offer to the Holders of the
Securities (the "Registered Exchange Offer") who are not prohibited by any law
or policy of the Commission from participating in the Registered Exchange Offer
to issue and deliver to such Holders, in exchange for the Securities, a like
aggregate principal amount of debt securities of the Company (the "Exchange
Securities") that are identical in all material respects to the Securities,
except for the transfer restrictions relating to the Securities and the
provisions related to the matters described in Section 3 hereof, (ii) use their
reasonable best efforts to cause the Exchange Offer Registration Statement to
become effective under the Securities Act no later than 105 days after the
Acquisition Date and the Registered Exchange Offer to be consummated no later
than 135 days after the Acquisition Date and (iii) keep the Exchange Offer
Registration Statement effective for not less than 30 days (or longer, if
required by applicable law) after the date on which notice of the Registered
Exchange Offer is mailed to the Holders (such period being called the "Exchange
Offer Registration Period"). The Exchange Securities will be issued under the
Indenture or an indenture (the "Exchange Securities Indenture") between the
Company, the Guarantors and the Trustee or such other bank or trust company that
is reasonably satisfactory to the Initial Purchasers, as trustee (the "Exchange
Securities Trustee"), such indenture to be identical in all material respects to
the Indenture, except for the transfer restrictions relating to the Securities
(as described above) and the provisions related to the matters described in
Section 3 hereof.

                  Upon the effectiveness of the Exchange Offer Registration
Statement, the Company and the Guarantors shall promptly commence the Registered
Exchange Offer, it being the objective of such Registered Exchange Offer to
enable each Holder electing to exchange Securities for Exchange Securities
(assuming that such Holder (a) is not an affiliate of the Company or an
Exchanging Dealer (as defined herein) not complying with the requirements of the
next sentence, (b) is not an Initial Purchaser holding Securities that have, or
that are reasonably likely to have, the status of an unsold allotment in an
initial distribution, (c) acquires the Exchange Securities in the ordinary
course of such Holder's business and (d) has no arrangements or understandings
with any person to participate in the distribution of the Exchange

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Securities and is not prohibited by any law or policy of the Commission from
participating in the Registered Exchange Offer) and to trade such Exchange
Securities from and after their receipt without any limitations or restrictions
under the Securities Act and without material restrictions under the securities
laws of the several states of the United States. The Company, the Select
Guarantors, the Initial Purchasers and each Exchanging Dealer acknowledge that,
pursuant to current interpretations by the Commission's staff of Section 5 of
the Securities Act, each Holder that is a broker-dealer electing to exchange
Securities, acquired for its own account as a result of market-making activities
or other trading activities, for Exchange Securities (an "Exchanging Dealer"),
is required to deliver a prospectus containing substantially the information set
forth in Annex A hereto on the cover, in Annex B hereto in the "Exchange Offer
Procedures" section and the "Purpose of the Exchange Offer" section and in Annex
C hereto in the "Plan of Distribution" section of such prospectus in connection
with a sale of any such Exchange Securities received by such Exchanging Dealer
pursuant to the Registered Exchange Offer.

                  If, prior to the consummation of the Registered Exchange
Offer, any Holder holds any Securities acquired by it that have, or that are
reasonably likely to be determined to have, the status of an unsold allotment in
an initial distribution, or any Holder is not entitled to participate in the
Registered Exchange Offer, the Company shall, upon the request of any such
Holder, simultaneously with the delivery of the Exchange Securities in the
Registered Exchange Offer, issue and deliver to any such Holder, in exchange for
the Securities held by such Holder (the "Private Exchange"), a like aggregate
principal amount of debt securities of the Company (the "Private Exchange
Securities") that are identical in all material respects to the Exchange
Securities, except for the transfer restrictions relating to such Private
Exchange Securities. The Private Exchange Securities will be issued under the
same indenture as the Exchange Securities, and the Company shall use its
reasonable best efforts to cause the Private Exchange Securities to bear the
same CUSIP number as the Exchange Securities.

                  In connection with the Registered Exchange Offer, the Company
shall:

                  (a) mail to each Holder a copy of the prospectus forming part
         of the Exchange Offer Registration Statement, together with an
         appropriate letter of transmittal and related documents;

                  (b) keep the Registered Exchange Offer open for not less than
         30 days (or longer, if required by applicable law) after the date on
         which notice of the Registered Exchange Offer is mailed to the Holders;

                  (c) utilize the services of a depositary for the Registered
         Exchange Offer with an address in the Borough of Manhattan, The City of
         New York, which may be the Trustee or an affiliate of the Trustee;

                  (d) permit Holders to withdraw tendered Securities at any time
         prior to the close of business, New York City time, on the last
         business day on which the Registered Exchange Offer shall remain open;
         and

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                  (e) otherwise comply in all respects with all laws that are
         applicable to the Registered Exchange Offer.

                  As soon as practicable after the close of the Registered
         Exchange Offer and any Private Exchange, as the case may be, the
         Company shall:

                  (a)      accept for exchange all Securities validly tendered
         and not validly withdrawn pursuant to the Registered Exchange Offer and
         the Private Exchange;

                  (b)      deliver to the Trustee for cancellation all
         Securities so accepted for exchange; and

                  (c)      cause the Trustee or the Exchange Securities Trustee,
         as the case may be, promptly to authenticate and deliver to each
         Holder, Exchange Securities or Private Exchange Securities, as the case
         may be, equal in principal amount to the Securities of such Holder so
         accepted for exchange.

                  The Company and the Guarantors shall use their reasonable best
efforts to keep the Exchange Offer Registration Statement effective and to amend
and supplement the prospectus contained therein in order to permit such
prospectus to be used by all persons subject to the prospectus delivery
requirements of the Securities Act for such period of time as such persons must
comply with such requirements in order to resell the Exchange Securities;
provided that (i) in the case where such prospectus and any amendment or
supplement thereto must be delivered by an Exchanging Dealer or an Initial
Purchaser, such period shall be the lesser of 180 days and the date on which all
Exchanging Dealers and the Initial Purchasers have sold all Exchange Securities
held by them and (ii) the Company shall make such prospectus and any amendment
or supplement thereto available to any broker-dealer for use in connection with
any resale of any Exchange Securities for a period of not less than 90 days
after the consummation of the Registered Exchange Offer.

                  The Indenture or the Exchange Securities Indenture, as the
case may be, shall provide that the Securities, the Exchange Securities and the
Private Exchange Securities shall vote and consent together on all matters as
one class and that none of the Securities, the Exchange Securities or the
Private Exchange Securities will have the right to vote or consent as a separate
class from one another on any matter.

                  Interest on each Exchange Security and Private Exchange
Security issued pursuant to the Registered Exchange Offer and in the Private
Exchange will accrue from the last interest payment date on which interest was
paid on the Securities surrendered in exchange therefor or, if no interest has
been paid on the Securities, from the Issue Date.

                  Each Holder participating in the Registered Exchange Offer
shall be required to represent to the Company in writing that at the time of the
consummation of the Registered Exchange Offer (i) any Exchange Securities
received by such Holder will be acquired in the ordinary course of business,
(ii) such Holder will have no arrangements or understanding with any person to
participate in the distribution of the Securities or the Exchange Securities
within

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the meaning of the Securities Act, (iii) such Holder is not an affiliate of the
Company or, if it is such an affiliate, such Holder will comply with the
registration and prospectus delivery requirements of the Securities Act to the
extent applicable, (iv) if such Holder is not a broker-dealer, that it is not
engaged in, and does not intend to engage in, the distribution of the Exchange
Securities and (v) if such Holder is a broker-dealer, that it will receive
Exchange Securities for its own account in exchange for Securities that were
acquired as a result of market-making activities or other trading activities and
that it will be required to acknowledge that it will deliver a prospectus in
connection with any resale of such Exchange Securities.

                  Notwithstanding any other provisions hereof, the Company and
the Guarantors will ensure that (i) any Exchange Offer Registration Statement
and any amendment thereto and any prospectus forming part thereof and any
supplement thereto complies in all material respects with the Securities Act and
the rules and regulations of the Commission thereunder, (ii) any Exchange Offer
Registration Statement and any amendment thereto does not, when it becomes
effective, contain an untrue statement of a material fact or omit to state a
material fact required to be stated therein or necessary to make the statements
therein not misleading and (iii) any prospectus forming part of any Exchange
Offer Registration Statement, and any supplement to such prospectus, does not,
as of the consummation of the Registered Exchange Offer, include an untrue
statement of a material fact or omit to state a material fact necessary in order
to make the statements therein, in the light of the circumstances under which
they were made, not misleading.

                  2. Shelf Registration. If (i) because of any change or
development in law or applicable interpretations thereof by the Commission's
staff the Company and the Guarantors are not permitted, or for any other reason
the Commission does not permit the Company and the Guarantors, to effect the
Registered Exchange Offer as contemplated by Section 1 hereof, or (ii) any
Securities validly tendered pursuant to the Registered Exchange Offer are not
exchanged for Exchange Securities within 135 days after the Acquisition Date, or
(iii) any Initial Purchaser so requests with respect to Securities or Private
Exchange Securities not eligible to be exchanged for Exchange Securities in the
Registered Exchange Offer and held by it following the consummation of the
Registered Exchange Offer, or (iv) any applicable law or interpretations do not
permit any Holder to participate in the Registered Exchange Offer, or (v) any
Holder that participates in the Registered Exchange Offer does not receive
freely transferable Exchange Securities in exchange for tendered Securities, or
(vi) the Company so elects, then the following provisions shall apply:

                  (a) The Company and the Guarantors shall use their reasonable
         best efforts to file as promptly as practicable (but in no event more
         than 30 days after so required or requested pursuant to this Section 2)
         with the Commission, and thereafter shall use their reasonable best
         efforts to cause to be declared effective, a shelf registration
         statement on an appropriate form under the Securities Act relating to
         the offer and sale of the Transfer Restricted Securities (as defined
         below) by the Holders thereof from time to time in accordance with the
         methods of distribution set forth in such registration statement
         (hereafter, a "Shelf Registration Statement" and, together with any
         Exchange Offer Registration Statement, a "Registration Statement")
         provided, however, that no Holder (other than an Initial Purchaser)
         shall be entitled to have the Securities, the Exchange

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         Securities or the Private Exchange Securities held by it covered by the
         Shelf Registration Statement unless such Holder agrees in writing to be
         bound by all the provisions of this Agreement applicable to such
         Holder.

                  (b) The Company and the Guarantors shall use their reasonable
         best efforts to keep the Shelf Registration Statement continuously
         effective and available in order to permit the prospectus forming part
         thereof to be used by Holders of Transfer Restricted Securities for a
         period ending on the earlier of (i) two years from the Issue Date or
         such shorter period that will terminate when all the Transfer
         Restricted Securities covered by the Shelf Registration Statement have
         been sold pursuant thereto and (ii) the date on which the Securities
         become eligible for resale without volume restrictions pursuant to Rule
         144 under the Securities Act (in any such case, such period being
         called the "Shelf Registration Period"). The Company and the Guarantors
         shall be deemed not to have used their reasonable best efforts to keep
         the Shelf Registration Statement effective during the requisite period
         if they voluntarily take any action that would result in Holders of
         Transfer Restricted Securities covered thereby not being able to offer
         and sell such Transfer Restricted Securities during that period, unless
         such action is required by applicable law.

                  (c) Notwithstanding any other provisions hereof, the Company
         and the Guarantors will ensure that (i) any Shelf Registration
         Statement and any amendment thereto and any prospectus forming part
         thereof and any supplement thereto complies in all material respects
         with the Securities Act and the rules and regulations of the Commission
         thereunder, (ii) any Shelf Registration Statement and any amendment
         thereto (in either case, other than with respect to information
         included therein in reliance upon or in conformity with written
         information furnished to the Company by or on behalf of any Holder
         specifically for use therein (the "Holders' Information")) does not
         contain an untrue statement of a material fact or omit to state a
         material fact required to be stated therein or necessary to make the
         statements therein not misleading and (iii) any prospectus forming part
         of any Shelf Registration Statement, and any supplement to such
         prospectus (in either case, other than with respect to Holders'
         Information), does not include an untrue statement of a material fact
         or omit to state a material fact necessary in order to make the
         statements therein, in the light of the circumstances under which they
         were made, not misleading.

                  3.       Additional Interest.

                  (a) The parties hereto agree that the Holders of Transfer
Restricted Securities will suffer damages if the Company and the Guarantors fail
to fulfill their obligations under Section 1 or Section 2, as applicable, and
that it would not be feasible to ascertain the extent of such damages.
Accordingly, if (i) the Exchange Offer Registration Statement is not filed with
the Commission on or prior to 45 days after the Acquisition Date or the Shelf
Registration Statement is not filed with the Commission on or prior to 30 days
after required to be filed or requested to be filed pursuant to Section 2
hereof, (ii) the Exchange Offer Registration Statement or the Shelf Registration
Statement, as the case may be, is not declared effective within 105 days after
the Acquisition Date (or in the case of a Shelf Registration Statement required
to be filed in response to a change or development in law or the applicable
interpretation of the Commission's staff, if later, within 60 days after
publication or the Company otherwise is notified of the change or development in
law or interpretation), (iii) the Registered Exchange Offer is not consummated
on or prior to 135 days after the Acquisition Date, or (iv) the Shelf
Registration Statement is filed and declared effective within 105 days after the

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Acquisition Date (or in the case of a Shelf Registration Statement required to
be filed in response to a change or development in law or the applicable
interpretation of the Commission's staff, if later, within 60 days after
publication or the Company otherwise is notified of the change or development in
law or interpretation) but shall thereafter cease to be effective or available
for the Holders of Transfer Restricted Securities to offer and sell such
Transfer Restricted Securities (at any time that the Company and the Guarantors
are obligated to maintain the effectiveness thereof) without either being
succeeded by an additional Registration Statement filed and declared effective
or such Shelf Registration Statement otherwise becoming available again, in
either case within 30 days (or in any case if the aggregate number of days for
which such Shelf Registration Statement has not been effective and available for
the Holders of Transfer Restricted Securities to offer and sell such Transfer
Restricted Securities within the preceding 360 days exceeds 45 days) (each such
event referred to in clauses (i) through (iv), a "Registration Default"), the
Company, Select Medical Escrow and the Guarantors will be jointly and severally
obligated to pay additional interest to each Holder of Transfer Restricted
Securities, during the period of one or more such Registration Defaults, in an
amount equal to $ 0.192 per week per $1,000 principal amount of Transfer
Restricted Securities held by such Holder until (i) the applicable Registration
Statement is filed, (ii) the Exchange Offer Registration Statement is declared
effective and the Registered Exchange Offer is consummated, (iii) the Shelf
Registration Statement is declared effective or (iv) the Shelf Registration
Statement again becomes effective and available, as the case may be. Following
the cure of all Registration Defaults, the accrual of additional interest will
cease. As used herein, the term "Transfer Restricted Securities" means each
Security or Private Exchange Security, until the earliest to occur of: (i) the
date on which such Security has been exchanged for a freely transferable
Exchange Security in the Registered Exchange Offer, (ii) the date on which such
Security or Private Exchange Security has been effectively registered under the
Securities Act and disposed of in accordance with the Shelf Registration
Statement or (iii) the date on which such Security or Private Exchange Security
is distributed to the public pursuant to Rule 144 under the Securities Act or is
saleable pursuant to Rule 144(k) under the Securities Act. Notwithstanding
anything to the contrary in this Section 3(a), neither the Company nor the
Guarantors shall be required to pay additional interest to a Holder of Transfer
Restricted Securities if such Holder failed to comply with its obligations to
make the representations set forth in the second to last paragraph of Section 1
or failed to provide the information required to be provided by it, if any,
pursuant to Section 4(n).

                  (b) The Company shall notify the Trustee and the Paying Agent
under the Indenture immediately upon the happening of each and every
Registration Default. The Company and the Guarantors shall pay the additional
interest due on the Transfer Restricted Securities by depositing with the Paying
Agent (which may not be the Company for these purposes), in trust, for the
benefit of the Holders thereof, prior to 10:00 a.m., New York City time, on the
next interest payment date specified by the Indenture and the Securities, sums

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sufficient to pay the additional interest then due. The additional interest due
shall be payable on each interest payment date specified by the Indenture and
the Securities to the record holder entitled to receive the interest payment to
be made on such date. Each obligation to pay additional interest shall be deemed
to accrue from and including the date of the applicable Registration Default.

                  (c) The parties hereto agree that the additional interest
provided for in this Section 3 constitutes a reasonable estimate of and are
intended to constitute the sole damages that will be suffered by Holders of
Transfer Restricted Securities by reason of the failure of (i) the Shelf
Registration Statement or the Exchange Offer Registration Statement to be filed,
(ii) the Shelf Registration Statement to remain effective or (iii) the Exchange
Offer Registration Statement to be declared effective and the Registered
Exchange Offer to be consummated, in each case to the extent required by this
Agreement.

                  4. Registration Procedures. In connection with any
Registration Statement, the following provisions shall apply:

                  (a) The Company shall (i) furnish to each Initial Purchaser
         and counsel for the Initial Purchasers, prior to the filing thereof
         with the Commission, a copy of the Registration Statement and each
         amendment thereof and each supplement, if any, to the prospectus
         included therein and shall use its reasonable best efforts to reflect
         in each such document, when so filed with the Commission, such comments
         as any Initial Purchaser may reasonably propose; (ii) include the
         information set forth in Annex A hereto on the cover, in Annex B hereto
         in the "Exchange Offer Procedures" section and the "Purpose of the
         Exchange Offer" section and in Annex C hereto in the "Plan of
         Distribution" section of the prospectus forming a part of the Exchange
         Offer Registration Statement, and include the information set forth in
         Annex D hereto in the Letter of Transmittal delivered pursuant to the
         Registered Exchange Offer; and (iii) if requested by any Initial
         Purchaser, include the information required by Items 507 or 508 of
         Regulation S-K, as applicable, in the prospectus forming a part of the
         Exchange Offer Registration Statement.

                  (b) The Company shall advise each Initial Purchaser, each
         Exchanging Dealer and the Holders (if applicable) and, if requested by
         any such person, confirm such advice in writing (which advice pursuant
         to clauses (ii) - (v) hereof shall be accompanied by an instruction to
         suspend the use of the prospectus until the requisite changes have been
         made):

                           (i)      when any Registration Statement and any
                  amendment thereto has been filed with the Commission and when
                  such Registration Statement or any post-effective amendment
                  thereto has become effective;

                           (ii)     of any request by the Commission for
                  amendments or supplements to any Registration Statement or the
                  prospectus included therein or for additional information;

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                           (iii)    of the issuance by the Commission of any
                  stop order suspending the effectiveness of any Registration
                  Statement or the initiation of any proceedings for that
                  purpose;

                           (iv)     of the receipt by the Company of any
                  notification with respect to the suspension of the
                  qualification of the Securities, the Exchange Securities or
                  the Private Exchange Securities for sale in any jurisdiction
                  or the initiation or threatening of any proceeding for such
                  purpose; and

                           (v)      of the happening of any event that requires
                  the making of any changes in any Registration Statement or the
                  prospectus included therein in order that the statements or
                  material facts therein are true and do not omit to state a
                  material fact required to be stated therein or necessary to
                  make the statements therein (in case of the prospectus, in
                  light of the circumstances under which they were made) not
                  misleading.

                  (c) The Company and the Guarantors will make every reasonable
         effort to obtain the withdrawal at the earliest possible time of any
         order suspending the effectiveness of any Registration Statement.

                  (d) The Company will furnish to each Holder of Transfer
         Restricted Securities included within the coverage of any Shelf
         Registration Statement, without charge, at least one conformed copy of
         such Shelf Registration Statement and any post-effective amendment
         thereto, including financial statements and schedules and, if any such
         Holder so requests in writing, all exhibits thereto (including those,
         if any, incorporated by reference).

                  (e) The Company will, during the Shelf Registration Period,
         promptly deliver to each Holder of Transfer Restricted Securities
         included within the coverage of any Shelf Registration Statement,
         without charge, as many copies of the prospectus (including each
         preliminary prospectus) included in such Shelf Registration Statement
         and any amendment or supplement thereto as such Holder may reasonably
         request; and the Company consents, subject to the provisions of this
         Agreement to the use of such prospectus or any amendment or supplement
         thereto by each of the selling Holders of Transfer Restricted
         Securities in connection with the offer and sale of the Transfer
         Restricted Securities covered by such prospectus or any amendment or
         supplement thereto.

                  (f) The Company will furnish to each Initial Purchaser and
         each Exchanging Dealer, and to any other Holder who so requests,
         without charge, at least one conformed copy of the Exchange Offer
         Registration Statement and any post-effective amendment thereto,
         including financial statements and schedules and, if any Initial
         Purchaser or Exchanging Dealer or any such Holder so requests in
         writing, all exhibits thereto (including those, if any, incorporated by
         reference).

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                  (g) The Company will, during the Exchange Offer Registration
         Period or the Shelf Registration Period, as applicable, promptly
         deliver to each Initial Purchaser, each Exchanging Dealer and such
         other persons that are required to deliver a prospectus following the
         Registered Exchange Offer, without charge, as many copies of the final
         prospectus included in the Exchange Offer Registration Statement or the
         Shelf Registration Statement and any amendment or supplement thereto as
         such Initial Purchaser, Exchanging Dealer or other persons may
         reasonably request; and the Company and the Guarantors consent to the
         use of such prospectus or any amendment or supplement thereto by any
         such Initial Purchaser, Exchanging Dealer or other persons, as
         applicable, as aforesaid. Any information designated in good faith by
         the Company as confidential shall be kept confidential by the Inspector
         or their agents and representatives.

                  (h) Prior to the effective date of any Registration Statement,
         the Company and the Guarantors will use their reasonable best efforts
         to register or qualify, or cooperate with the Holders of Securities,
         Exchange Securities or Private Exchange Securities included therein and
         their respective counsel in connection with the registration or
         qualification of, such Securities, Exchange Securities or Private
         Exchange Securities for offer and sale under the securities or blue sky
         laws of such jurisdictions as any such Holder reasonably requests in
         writing and do any and all other acts or things necessary or advisable
         to enable the offer and sale in such jurisdictions of the Securities,
         Exchange Securities or Private Exchange Securities covered by such
         Registration Statement; provided that the Company and the Guarantors
         will not be required to qualify generally to do business in any
         jurisdiction where it is not then so qualified or to take any action
         which would subject it to general service of process or to taxation in
         any such jurisdiction where it is not then so subject.

                  (i) The Company and the Guarantors will cooperate with the
         Holders of Securities, Exchange Securities or Private Exchange
         Securities to facilitate the timely preparation and delivery of
         certificates representing Securities, Exchange Securities or Private
         Exchange Securities to be sold pursuant to any Registration Statement
         free of any restrictive legends and in such denominations and
         registered in such names as the Holders thereof may request in writing
         prior to sales of Securities, Exchange Securities or Private Exchange
         Securities pursuant to such Registration Statement.

                  (j) If any event contemplated by Section 4(b)(ii) through (v)
         occurs during the period for which the Company and the Guarantors are
         required to maintain an effective Registration Statement, the Company
         will promptly prepare and file with the Commission a post-effective
         amendment to the Registration Statement or a supplement to the related
         prospectus or file any other required document so that, as thereafter
         delivered to purchasers of the Securities, Exchange Securities or
         Private Exchange Securities from a Holder, the prospectus will not
         include an untrue statement of a material fact or omit to state a
         material fact necessary in order to make the statements therein, in the
         light of the circumstances under which they were made, not misleading.

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                  (k) Not later than the effective date of the applicable
         Registration Statement, the Company will provide a CUSIP number for the
         Securities, the Exchange Securities and the Private Exchange
         Securities, as the case may be, and provide the applicable trustee with
         printed certificates for the Securities, the Exchange Securities or the
         Private Exchange Securities, as the case may be, in a form eligible for
         deposit with The Depository Trust Company.

                  (l) The Company and the Guarantors will comply with all
         applicable rules and regulations of the Commission and will make
         generally available to its security holders as soon as practicable
         after the effective date of the applicable Registration Statement an
         earning statement satisfying the provisions of Section 11(a) of the
         Securities Act; provided that in no event shall such earning statement
         be delivered later than 45 days after the end of a 12-month period (or
         90 days, if such period is a fiscal year) beginning with the first
         month of the Company's first fiscal quarter commencing after the
         effective date of the applicable Registration Statement, which
         statement shall cover such 12-month period.

                  (m) The Company and the Guarantors will cause the Indenture or
         the Exchange Securities Indenture, as the case may be, to be qualified
         under the Trust Indenture Act as required by applicable law in a timely
         manner.

                  (n) The Company may require each Holder of Transfer Restricted
         Securities to be registered pursuant to any Shelf Registration
         Statement to furnish to the Company such information concerning the
         Holder and the distribution of such Transfer Restricted Securities as
         the Company may from time to time reasonably require for inclusion in
         such Shelf Registration Statement, and the Company may exclude from
         such registration the Transfer Restricted Securities of any Holder that
         fails to furnish such information within a reasonable time after
         receiving such request.

                  (o) In the case of a Shelf Registration Statement, each Holder
         of Transfer Restricted Securities to be registered pursuant thereto
         agrees by acquisition of such Transfer Restricted Securities that, upon
         receipt of any notice from the Company pursuant to Section 4(b)(ii)
         through (v), such Holder will discontinue disposition of such Transfer
         Restricted Securities until such Holder's receipt of copies of the
         supplemental or amended prospectus contemplated by Section 4(j) or
         until advised in writing (the "Advice") by the Company that the use of
         the applicable prospectus may be resumed. If the Company shall give any
         notice under Section 4(b)(ii) through (v) during the period that the
         Company is required to maintain an effective Registration Statement
         (the "Effectiveness Period"), such Effectiveness Period shall be
         extended by the number of days during such period from and including
         the date of the giving of such notice to and including the date when
         each seller of Transfer Restricted Securities covered by such
         Registration Statement shall have received (x) the copies of the
         supplemental or amended prospectus contemplated by Section 4(j) (if an
         amended or supplemental prospectus is required) or (y) the Advice (if
         no amended or supplemental prospectus is required).

                                       11

<PAGE>

                  (p) In the case of a Shelf Registration Statement, the Company
         and the Guarantors shall enter into such customary agreements
         (including, if requested, an underwriting agreement in customary form)
         and take all such other action, if any, as Holders of a majority in
         aggregate principal amount of the Securities, Exchange Securities and
         Private Exchange Securities being sold or the managing underwriters (if
         any) shall reasonably request in order to facilitate any disposition of
         Securities, Exchange Securities or Private Exchange Securities pursuant
         to such Shelf Registration Statement.

                  (q) In the case of a Shelf Registration Statement, the Company
         shall (i) make reasonably available for inspection by a representative
         of, and Special Counsel (as defined below) acting for, Holders of a
         majority in aggregate principal amount of the Securities, Exchange
         Securities and Private Exchange Securities being sold and any
         underwriter participating in any disposition of Securities, Exchange
         Securities or Private Exchange Securities pursuant to such Shelf
         Registration Statement, all relevant financial and other records,
         pertinent corporate documents and properties of the Company and its
         subsidiaries and (ii) use its reasonable best efforts to have its
         officers, directors, employees, accountants and counsel supply all
         relevant information reasonably requested by such representative,
         Special Counsel or any such underwriter (an "Inspector") in connection
         with such Shelf Registration Statement.

                  (r) In the case of a Shelf Registration Statement, the Company
         shall, if requested by Holders of a majority in aggregate principal
         amount of the Securities, Exchange Securities and Private Exchange
         Securities being sold, their Special Counsel or the managing
         underwriters (if any) in connection with such Shelf Registration
         Statement, use its reasonable best efforts to cause (i) its counsel to
         deliver an opinion relating to the Shelf Registration Statement and the
         Securities, Exchange Securities or Private Exchange Securities, as
         applicable, in customary form, (ii) its officers to execute and deliver
         all customary documents and certificates requested by Holders of a
         majority in aggregate principal amount of the Securities, Exchange
         Securities and Private Exchange Securities being sold, their Special
         Counsel or the managing underwriters (if any) and (iii) its independent
         public accountants to provide a comfort letter or letters in customary
         form, subject to receipt of appropriate documentation as contemplated,
         and only if permitted, by Statement of Auditing Standards No. 72.

                  5. Registration Expenses. The Company and the Guarantors will
bear all expenses incurred in connection with the performance of its obligations
under Sections 1, 2, 3 and 4 and the Company will reimburse the Initial
Purchasers and the Holders for the reasonable fees and disbursements of one firm
of attorneys (in addition to any local counsel) chosen by the Holders of a
majority in aggregate principal amount of the Securities, the Exchange
Securities and the Private Exchange Securities, as the case may be, to be sold
pursuant to each Registration Statement (the "Special Counsel") acting for the
Initial Purchasers or Holders in connection therewith.

                  6. Indemnification.

                                       12

<PAGE>

                  (a) In the event of a Shelf Registration Statement or in
connection with any prospectus delivery pursuant to an Exchange Offer
Registration Statement by an Initial Purchaser or Exchanging Dealer, as
applicable, the Company and each of the Guarantors shall jointly and severally
indemnify and hold harmless each Holder (including, without limitation, any such
Initial Purchaser or Exchanging Dealer), its affiliates, their respective
officers, directors, employees, representatives and agents, and each person, if
any, who controls such Holder within the meaning of the Securities Act or the
Exchange Act (collectively referred to for purposes of this Section 6 and
Section 7 as a Holder) from and against any loss, claim, damage or liability,
joint or several, or any action in respect thereof (including, without
limitation, any loss, claim, damage, liability or action relating to purchases
and sales of Securities, Exchange Securities or Private Exchange Securities), to
which that Holder may become subject, whether commenced or threatened, under the
Securities Act, the Exchange Act, any other federal or state statutory law or
regulation, at common law or otherwise, insofar as such loss, claim, damage,
liability or action arises out of, or is based upon, (i) any untrue statement or
alleged untrue statement of a material fact contained in any such Registration
Statement or any prospectus forming part thereof or in any amendment or
supplement thereto or (ii) the omission or alleged omission to state therein a
material fact required to be stated therein or necessary in order to make the
statements therein, in the light of the circumstances under which they were
made, not misleading, and shall reimburse each Holder promptly upon demand for
any legal or other expenses reasonably incurred by that Holder in connection
with investigating or defending or preparing to defend against or appearing as a
third party witness in connection with any such loss, claim, damage, liability
or action as such expenses are incurred; provided, however, that the Company and
the Guarantors shall not be liable in any such case to the extent that any such
loss, claim, damage, liability or action arises out of, or is based upon, an
untrue statement or alleged untrue statement in or omission or alleged omission
from any of such documents in reliance upon and in conformity with any Holders'
Information; and provided, further, that with respect to any such untrue
statement in or omission from any related preliminary prospectus, the indemnity
agreement contained in this Section 6(a) shall not inure to the benefit of any
Holder from whom the person asserting any such loss, claim, damage, liability or
action received Securities, Exchange Securities or Private Exchange Securities
to the extent that such loss, claim, damage, liability or action of or with
respect to such Holder results from the fact that both (A) a copy of the final
prospectus was not sent or given to such person at or prior to the written
confirmation of the sale of such Securities, Exchange Securities or Private
Exchange Securities to such person and (B) the untrue statement in or omission
from the related preliminary prospectus was corrected in the final prospectus
unless, in either case, such failure to deliver the final prospectus was a
result of non-compliance by the Company with Section 4(d), 4(e), 4(f) or 4(g).

                  (b) In the event of a Shelf Registration Statement, each
Holder shall indemnify and hold harmless the Company, each Guarantor and their
respective affiliates, their respective officers, directors, employees,
representatives and agents, and each person, if any, who controls the Company or
any Guarantor within the meaning of the Securities Act or the Exchange Act
(collectively referred to for purposes of this Section 6(b) and Section 7 as the
Company), from and against any loss, claim, damage or liability, joint or
several, or any action in respect thereof, to which the Company may become
subject, whether commenced or threatened, under the Securities Act, the Exchange
Act, any other federal or state statutory law or regulation, at

                                       13

<PAGE>

common law or otherwise, insofar as such loss, claim, damage, liability or
action arises out of, or is based upon, (i) any untrue statement or alleged
untrue statement of a material fact contained in any such Registration Statement
or any prospectus forming part thereof or in any amendment or supplement thereto
or (ii) the omission or alleged omission to state therein a material fact
required to be stated therein or necessary in order to make the statements
therein, in the light of the circumstances under which they were made, not
misleading, but in each case only to the extent that the untrue statement or
alleged untrue statement or omission or alleged omission was made in reliance
upon and in conformity with any Holders' Information furnished to the Company by
such Holder, and shall reimburse the Company for any legal or other expenses
reasonably incurred by the Company in connection with investigating or defending
or preparing to defend against or appearing as a third party witness in
connection with any such loss, claim, damage, liability or action as such
expenses are incurred; provided, however, that no such Holder shall be liable
for any indemnity claims hereunder in excess of the amount of net proceeds
received by such Holder from the sale of Securities, Exchange Securities or
Private Exchange Securities pursuant to such Shelf Registration Statement.

                  (c) Promptly after receipt by an indemnified party under this
Section 6 of notice of any claim or the commencement of any action, the
indemnified party shall, if a claim in respect thereof is to be made against the
indemnifying party pursuant to Section 6(a) or 6(b), notify the indemnifying
party in writing of the claim or the commencement of that action; provided,
however, that the failure to notify the indemnifying party shall not relieve it
from any liability which it may have under this Section 6 except to the extent
that it has been materially prejudiced (through the forfeiture of substantive
rights or defenses) by such failure; and provided, further, that the failure to
notify the indemnifying party shall not relieve it from any liability which it
may have to an indemnified party otherwise than under this Section 6. If any
such claim or action shall be brought against an indemnified party, and it shall
notify the indemnifying party thereof, the indemnifying party shall be entitled
to participate therein and, to the extent that it wishes, jointly with any other
similarly notified indemnifying party, to assume the defense thereof with
counsel reasonably satisfactory to the indemnified party. After notice from the
indemnifying party to the indemnified party of its election to assume the
defense of such claim or action, the indemnifying party shall not be liable to
the indemnified party under this Section 6 for any legal or other expenses
subsequently incurred by the indemnified party in connection with the defense
thereof other than the reasonable costs of investigation; provided, however,
that an indemnified party shall have the right to employ its own counsel in any
such action, but the fees, expenses and other charges of such counsel for the
indemnified party will be at the expense of such indemnified party unless (1)
the employment of counsel by the indemnified party has been authorized in
writing by the indemnifying party, (2) the indemnified party has reasonably
concluded (based upon advice of counsel to the indemnified party) that there may
be legal defenses available to it or other indemnified parties that are
different from or in addition to those available to the indemnifying party, (3)
a conflict or potential conflict exists (based upon advice of counsel to the
indemnified party) between the indemnified party and the indemnifying party (in
which case the indemnifying party will not have the right to direct the defense
of such action on behalf of the indemnified party) or (4) the indemnifying party
has not in fact employed counsel reasonably satisfactory to the indemnified
party to assume the defense of such action within a reasonable time after
receiving notice of the commencement of the action,

                                       14

<PAGE>

in each of which cases the reasonable fees, disbursements and other charges of
counsel will be at the expense of the indemnifying party or parties. It is
understood that the indemnifying party or parties shall not, in connection with
any proceeding or related proceedings in the same jurisdiction, be liable for
the reasonable fees, disbursements and other charges of more than one separate
firm of attorneys (in addition to any local counsel) at any one time for all
such indemnified party or parties. Each indemnified party, as a condition of the
indemnity agreements contained in Sections 6(a) and 6(b), shall use all
reasonable efforts to cooperate with the indemnifying party in the defense of
any such action or claim. No indemnifying party shall be liable for any
settlement of any such action effected without its written consent (which
consent shall not be unreasonably withheld), but if settled with its written
consent or if there be a final judgment for the plaintiff in any such action,
the indemnifying party agrees to indemnify and hold harmless any indemnified
party from and against any loss or liability by reason of such settlement or
judgment. No indemnifying party shall, without the prior written consent of the
indemnified party (which consent shall not be unreasonably withheld), effect any
settlement of any pending or threatened proceeding in respect of which any
indemnified party is or could have been a party and indemnity could have been
sought hereunder by such indemnified party, unless such settlement includes an
unconditional release of such indemnified party from all liability on claims
that are the subject matter of such proceeding.

                  7. Contribution. If the indemnification provided for in
Section 6 is unavailable or insufficient to hold harmless an indemnified party
under Section 6(a) or 6(b), then each indemnifying party shall, in lieu of
indemnifying such indemnified party, contribute to the amount paid or payable by
such indemnified party as a result of such loss, claim, damage or liability, or
action in respect thereof, (i) in such proportion as shall be appropriate to
reflect the relative benefits received by the Company and the Guarantors from
the offering and sale of the Securities, on the one hand, and a Holder with
respect to the sale by such Holder of Securities, Exchange Securities or Private
Exchange Securities, on the other, or (ii) if the allocation provided by clause
(i) above is not permitted by applicable law, in such proportion as is
appropriate to reflect not only the relative benefits referred to in clause (i)
above but also the relative fault of the Company and the Guarantors on the one
hand and such Holder on the other with respect to the statements or omissions
that resulted in such loss, claim, damage or liability, or action in respect
thereof, as well as any other relevant equitable considerations. The relative
benefits received by the Company and the Guarantors on the one hand and a Holder
on the other with respect to such offering and such sale shall be deemed to be
in the same proportion as the total net proceeds from the offering of the
Securities (before deducting expenses) received by or on behalf of the Company
as set forth in the table on the cover of the Offering Memorandum, on the one
hand, bear to the total proceeds received by such Holder with respect to its
sale of Securities, Exchange Securities or Private Exchange Securities, on the
other. The relative fault shall be determined by reference to, among other
things, whether the untrue or alleged untrue statement of a material fact or the
omission or alleged omission to state a material fact relates to the information
supplied by the Company and the Guarantors on the one hand or to any Holders'
Information supplied by such Holder on the other, the intent of the parties and
their relative knowledge, access to information and opportunity to correct or
prevent such untrue statement or omission. The parties hereto agree that it
would not be just and equitable if contributions pursuant to this Section 7 were
to be determined by pro rata allocation or by any other method of

                                       15

<PAGE>

allocation that does not take into account the equitable considerations referred
to herein. The amount paid or payable by an indemnified party as a result of the
loss, claim, damage or liability, or action in respect thereof, referred to
above in this Section 7 shall be deemed to include, for purposes of this Section
7, any legal or other expenses reasonably incurred by such indemnified party in
connection with investigating or defending or preparing to defend any such
action or claim. Notwithstanding the provisions of this Section 7, an
indemnifying party that is a Holder of Securities, Exchange Securities or
Private Exchange Securities shall not be required to contribute any amount in
excess of the amount by which the total price at which the Securities, Exchange
Securities or Private Exchange Securities sold by such indemnifying party to any
purchaser exceeds the amount of any damages which such indemnifying party has
otherwise paid or become liable to pay by reason of any untrue or alleged untrue
statement or omission or alleged omission. No person guilty of fraudulent
misrepresentation (within the meaning of Section 11(f) of the Securities Act)
shall be entitled to contribution from any person who was not guilty of such
fraudulent misrepresentation.

                  8. Rules 144 and 144A. So long as any Transfer Restricted
Securities remain outstanding, the Company shall use its reasonable best efforts
to file the reports required to be filed by it under Rule 144(c)(1) under the
Securities Act and the Exchange Act in a timely manner and, if at any time the
Company is not required to file such reports, it will, upon the written request
of any Holder of Transfer Restricted Securities, make publicly available other
information so long as necessary to permit sales of such Holder's securities
pursuant to Rules 144 and 144A. The Company and the Guarantors covenant that
they will take such further action as any Holder of Transfer Restricted
Securities may reasonably request, all to the extent required from time to time
to enable such Holder to sell Transfer Restricted Securities without
registration under the Securities Act within the limitation of the exemptions
provided by Rules 144 and 144A (including, without limitation, the requirements
of Rule 144A(d)(4)). Upon the written request of any Holder of Transfer
Restricted Securities, the Company and the Guarantors shall deliver to such
Holder a written statement as to whether it has complied with such requirements.
Notwithstanding the foregoing, nothing in this Section 8 shall be deemed to
require the Company to register any of its securities pursuant to the Exchange
Act.

                  9. Underwritten Registrations. If any of the Transfer
Restricted Securities covered by any Shelf Registration Statement are to be sold
in an underwritten offering, the investment banker or investment bankers and
manager or managers that will administer the offering will be selected by the
Holders of a majority in aggregate principal amount of such Transfer Restricted
Securities included in such offering, subject to the consent of the Company
(which shall not be unreasonably withheld or delayed), and such Holders shall be
responsible for all underwriting commissions and discounts in connection
therewith.

                  No person may participate in any underwritten registration
hereunder unless such person (i) agrees to sell such person's Transfer
Restricted Securities on the basis reasonably provided in any underwriting
arrangements approved by the persons entitled hereunder to approve such
arrangements and (ii) completes and executes all questionnaires, powers of
attorney, indemnities, underwriting agreements and other documents reasonably
required under the terms of such underwriting arrangements.

                                       16

<PAGE>

                  10. Miscellaneous.

                  (a) Amendments and Waivers. The provisions of this Agreement
         may not be amended, modified or supplemented, and waivers or consents
         to departures from the provisions hereof may not be given, unless the
         Company has obtained the written consent of Holders of a majority in
         aggregate principal amount of the Securities, the Exchange Securities
         and the Private Exchange Securities, taken as a single class.
         Notwithstanding the foregoing, a waiver or consent to depart from the
         provisions hereof with respect to a matter that relates exclusively to
         the rights of Holders whose Securities, Exchange Securities or Private
         Exchange Securities are being sold pursuant to a Registration Statement
         and that does not directly or indirectly affect the rights of other
         Holders may be given by Holders of a majority in aggregate principal
         amount of the Securities, the Exchange Securities and the Private
         Exchange Securities being sold by such Holders pursuant to such
         Registration Statement.

                  (b) Notices. All notices and other communications provided for
or permitted hereunder shall be made in writing by hand-delivery, first-class
mail, telecopier or air courier guaranteeing next-day delivery:

                           (i)      if to a Holder, at the most current address
                  given by such Holder to the Company in accordance with the
                  provisions of this Section 10(b), which address initially is,
                  with respect to each Holder, the address of such Holder
                  maintained by the Registrar under the Indenture, with a copy
                  in like manner to JPMorgan, Merrill Lynch, Pierce, Fenner &
                  Smith Incorporated, Wachovia Capital Markets, LLC, SG Cowen
                  Securities Corporation, CIBC World Markets Corp., Fleet
                  Securities, Inc. and Jefferies & Company, Inc.;

                           (ii)     if to an Initial Purchaser, initially at its
                  address set forth in the Purchase Agreement; and

                           (iii)    if to the Company, Select Medical Escrow or
                  the Guarantors, initially at the address of the Company set
                  forth in the Purchase Agreement.

                  All such notices and communications shall be deemed to have
been duly given: when delivered by hand, if personally delivered; one business
day after being delivered to a next-day air courier; five business days after
being deposited in the mail; and when receipt is acknowledged by the recipient's
telecopier machine, if sent by telecopier.

                  (c) Successors And Assigns. This Agreement shall be binding
upon the Company, Select Medical Escrow, the Guarantors (but with respect to
Kessler and its subsidiaries, only upon the consummation of the Acquisition) and
their respective successors and assigns.

                  (d) Counterparts. This Agreement may be executed in any number
of counterparts (which may be delivered in original form or by telecopier) and
by the parties hereto

                                       17

<PAGE>

in separate counterparts, each of which when so executed shall be deemed to be
an original and all of which taken together shall constitute one and the same
agreement.

                  (e) Definition of Terms. For purposes of this Agreement, (a)
the term "business day" means any day on which the New York Stock Exchange, Inc.
is open for trading, (b) the term "subsidiary" has the meaning set forth in Rule
405 under the Securities Act and (c) except where otherwise expressly provided,
the term "affiliate" has the meaning set forth in Rule 405 under the Securities
Act.

                  (f) Headings. The headings in this Agreement are for
convenience of reference only and shall not limit or otherwise affect the
meaning hereof.

                  (g) Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of New York.

                  (h) Remedies. In the event of a breach by the Company, Select
Medical Escrow or any of the Guarantors or by any Holder of any of their
respective obligations under this Agreement, each Holder or the Company, Select
Medical Escrow or any Guarantor, as the case may be, in addition to being
entitled to exercise all rights granted by law, including recovery of damages
(other than the recovery of damages for a breach by the Company or any Guarantor
of their obligations under Sections 1 or 2 hereof for which additional interest
has been paid pursuant to Section 3 hereof), will be entitled to specific
performance of its rights under this Agreement. The Company, Select Medical
Escrow, each Guarantor and each Holder agree that monetary damages would not be
adequate compensation for any loss incurred by reason of a breach by it of any
of the provisions of this Agreement and hereby further agree that, in the event
of any action for specific performance in respect of such breach, it shall waive
the defense that a remedy at law would be adequate.

                  (i) No Inconsistent Agreements. The Company, Select Medical
Escrow and each Select Guarantor represents, warrants and agrees that (i) it has
not entered into, shall not, on or after the date of this Agreement, enter into
any agreement that is inconsistent with the rights granted to the Holders in
this Agreement or otherwise conflicts with the provisions hereof, (ii) it has
not previously entered into any agreement which remains in effect granting any
registration rights with respect to any of its debt securities to any person and
(iii) without limiting the generality of the foregoing, without the written
consent of the Holders of a majority in aggregate principal amount of the then
outstanding Transfer Restricted Securities, it shall not grant to any person the
right to request the Company to register any debt securities of the Company
under the Securities Act unless the rights so granted are not in conflict or
inconsistent with the provisions of this Agreement.

                  (j) No Piggyback on Registrations. Neither the Company nor the
Guarantors nor any of its security holders (other than the Holders of Transfer
Restricted Securities in such capacity) shall have the right to include any
securities of the Company in any Shelf Registration or Registered Exchange Offer
other than Transfer Restricted Securities.

                                       18

<PAGE>

                  (k) Severability. The remedies provided herein are cumulative
and not exclusive of any remedies provided by law. If any term, provision,
covenant or restriction of this Agreement is held by a court of competent
jurisdiction to be invalid, illegal, void or unenforceable, the remainder of the
terms, provisions, covenants and restrictions set forth herein shall remain in
full force and effect and shall in no way be affected, impaired or invalidated,
and the parties hereto shall use their reasonable best efforts to find and
employ an alternative means to achieve the same or substantially the same result
as that contemplated by such term, provision, covenant or restriction. It is
hereby stipulated and declared to be the intention of the parties that they
would have executed the remaining terms, provisions, covenants and restrictions
without including any of such that may be hereafter declared invalid, illegal,
void or unenforceable.

                                       19

<PAGE>

                  Please confirm that the foregoing correctly sets forth the
agreement among the Company, Select Medical Escrow, the Guarantors and the
Initial Purchasers.

                                             Very truly yours,

                                             SELECT MEDICAL CORPORATION

                                             By /s/ Michael E. Tarvin
                                                --------------------------------
                                                Name: Michael E. Tarvin
                                                Title: Senior Vice President

                                             SELECT MEDICAL ESCROW, INC.

                                             By /s/ Michael E. Tarvin
                                                --------------------------------
                                                Name: Michael E. Tarvin
                                                Title: Vice President

                                             SELECTMARK, INC.

                                             By /s/ Andrew T. Panaccione
                                                --------------------------------
                                                Name:Andrew T. Panaccione
                                                Title: Treasurer

                                             SELECT HOSPITAL INVESTORS, INC.

                                             By /s/ Andrew T. Panaccione
                                                --------------------------------
                                                Name: Andrew T. Panaccione
                                                Title:Vice President & Treasurer

                                             SLMC FINANCE CORPORATION

                                             By /s/ Andrew T. Panaccione
                                                --------------------------------
                                                Name: Andrew T. Panaccione
                                                Title: Treasurer

<PAGE>

                                             EACH OF THE GUARANTORS LISTED ON
                                             SCHEDULE I HERETO OTHER THAN
                                             SELECTMARK, INC., SELECT HOSPITAL
                                             INVESTORS, INC. AND SLMC FINANCE
                                             CORPORATION

                                             By /s/ Michael E. Tarvin
                                                --------------------------------
                                                Name: Michael E. Tarvin
                                                Title: Vice President

Accepted:

J.P. MORGAN SECURITIES INC.
for itself and on behalf
of the several Initial Purchasers

By /s/ Steve Tulip
   ---------------------------
     Authorized Signatory
<PAGE>

                                                                      SCHEDULE I

                                   GUARANTORS

Affiliated Physical Therapists, Ltd.

Allegany Hearing and Speech, Inc.

American Transitional Hospitals, Inc.

Athens Sports Medicine Clinic, Inc.

Ather Sports Injury Clinic, Inc.

Atlantic Health Group, Inc.

Atlantic Rehabilitation Services, Inc.

Avalon Rehabilitation & Healthcare, LLC

Buendel Physical Therapy, Inc.

C.E.R. - West, Inc.

C.O.A.S.T. Institute Physical Therapy, Inc.

CCISUB, Inc.

CMC Center Corporation

Cenla Physical Therapy & Rehabilitation Agency, Inc.

Center for Evaluation & Rehabilitation, Inc.

Center for Physical Therapy & Sports Rehabilitation, Inc.

CenterTherapy, Inc.

Champion Physical Therapy, Inc.

Connecticut NovaCare Ventures, Inc.

Coplin Physical Therapy Associates, Inc.

Crowley Physical Therapy Clinic, Inc.

Douglas Avery & Associates, Ltd.

Elk County Physical Therapy, Inc.

Fine, Bryant & Wah, Inc.

Francis Naselli, Jr. & Stewart Rich Physical Therapists, Inc.

Gallery Physical Therapy Center, Inc.

Georgia NovaCare Ventures, Inc.

Georgia Physical Therapy of West Georgia, Inc.

<PAGE>

Georgia Physical Therapy, Inc.

GP Therapy, L.L.C.

Greater Sacramento Physical Therapy Associates, Inc.

Grove City Physical Therapy and Sports Medicine, Inc.

Gulf Breeze Physical Therapy, Inc.

Gulf Coast Hand Specialists

Hand Therapy Associates, Inc.

Hand Therapy and Rehabilitation Associates, Inc.

Hangtown Physical Therapy, Inc.

Hawley Physical Therapy, Inc.

Hudson Physical Therapy Associates, Inc.

Human Performance and Fitness, Inc.

Indianapolis Physical Therapy and Sports Medicine, Inc.

Intensiva Healthcare Corporation

Intensiva Hospital of Greater St. Louis, Inc.

Joyner Sports Science Institute, Inc.

Joyner Sportsmedicine Institute, Inc.

Kentucky Rehabilitation Services, Inc.

Lynn M. Carlson, Inc.

Metro Rehabilitation Services, Inc.

Michigan Therapy Centre, Inc.

MidAtlantic Health Group, Inc.

Monmouth Rehabilitation, Inc.

New England Health Group, Inc

New Mexico Physical Therapists, Inc.

Northside Physical Therapy, Inc.

NovaCare Health Group, LLC

NovaCare Occupational Health Services, Inc.

NovaCare Outpatient Rehabilitation East, Inc.

NovaCare Outpatient Rehabilitation, Inc.

NovaCare Outpatient Rehabilitation of California, Inc.

<PAGE>

NovaCare Outpatient Rehabilitation West, Inc.

NovaCare Rehabilitation, Inc.

NW Rehabilitation Associates, L.P.

P.T. Services Company

P.T. Services, Inc.

P.T. Services Rehabilitation, Inc.

Peter Trailov R.P.T. Physical Therapy Clinic, Orthopedic Rehabilitation & Sports
Medicine, Ltd.

Physical Rehabilitation Partners, Inc.

Physical Therapy Enterprises, Inc.

Physical Therapy Institute, Inc.

Physical Therapy Services of the Jersey Cape, Inc.

Physio - Associates, Inc.

Pro Active Therapy, Inc.

Pro Active Therapy of Ahoskie, Inc.

Pro Active Therapy of Gaffney, Inc.

Pro Active Therapy of Greenville, Inc.

Pro Active Therapy of North Carolina, Inc.

Pro Active Therapy of Rocky Mount, Inc.

Pro Active Therapy of South Carolina, Inc.

Pro Active Therapy of Virginia, Inc.

Professional Therapeutic Services, Inc.

Quad City Management, Inc.

RCI (Colorado), Inc.

RCI (Exertec), Inc.

RCI (Michigan), Inc.

RCI (S.P.O.R.T.), Inc.

RCI (WRS), Inc.

Rebound Oklahoma, Inc.

Redwood Pacific Therapies, Inc.

Rehab Advantage, Inc.

Rehab Managed Care of Arizona, Inc.

<PAGE>

Rehab Provider Network - California, Inc.

Rehab Provider Network - East I, Inc.

Rehab Provider Network - East II, Inc.

Rehab Provider Network - Georgia, Inc.

Rehab Provider Network - Indiana, Inc.

Rehab Provider Network - Michigan, Inc.

Rehab Provider Network - New Jersey, Inc.

Rehab Provider Network - Ohio, Inc.

Rehab Provider Network - Oklahoma, Inc.

Rehab Provider Network - Pennsylvania, Inc.

Rehab Provider Network - Washington, D.C., Inc.

Rehab Provider Network of Colorado, Inc.

Rehab Provider Network of Florida, Inc.

Rehab Provider Network of Nevada, Inc.

Rehab Provider Network of New Mexico, Inc.

Rehab Provider Network of North Carolina, Inc.

Rehab Provider Network of Texas, Inc.

Rehab Provider Network of Wisconsin, Inc.

Rehab/Work Hardening Management Associates, Ltd.

RehabClinics, Inc.

RehabClinics (GALAXY), Inc.

RehabClinics (PTA), Inc.

RehabClinics (SPT), Inc.

RehabClinics Abilene, Inc.

RehabClinics Dallas, Inc.

RehabClinics Pennsylvania, Inc.

S.T.A.R.T., Inc.

Select Air II, Inc.

Select Employment Services, Inc.

Select Hospital Investors, Inc.

Select Management Services, LLC

<PAGE>

SelectMark, Inc.

Select Medical of Kentucky, Inc.

Select Medical of Maryland, Inc.

Select Medical of New Jersey, Inc.

Select Medical of New York, Inc.

Select Medical of Ohio, Inc.

Select Medical of Pennsylvania, Inc.

Select Medical Rehabilitation Clinics, Inc.

Select Provider Networks, Inc.

Select Rehabilitation Management Services, Inc.

Select Software Ventures, LLC

Select Specialty Hospital - Akron, Inc.

Select Specialty Hospital - Albuquerque

Select Specialty Hospital - Ann Arbor, Inc.

Select Specialty Hospital - Arizona, Inc.

Select Specialty Hospital - Battle Creek, Inc.

Select Specialty Hospital - Beech Grove, Inc.

Select Specialty Hospital - Bloomington, Inc.

Select Specialty Hospital - Boston, Inc.

Select Specialty Hospital - Central Detroit, Inc.

Select Specialty Hospital - Charleston, Inc.

Select Specialty Hospital - Cincinnati, Inc.

Select Specialty Hospital - Columbus, Inc.

Select Specialty Hospital - Columbus/Grant, Inc.

Select Specialty Hospital - Columbus/University, Inc.

Select Specialty Hospital - Conroe, Inc.

Select Specialty Hospital - Dallas, Inc.

Select Specialty Hospital - Denver, Inc.

Select Specialty Hospital - Durham, Inc.

Select Specialty Hospital - Erie, Inc.

Select Specialty Hospital - Escambia, Inc.

<PAGE>

Select Specialty Hospital - Evansville, Inc.

Select Specialty Hospital - Flint, Inc.

Select Specialty Hospital - Fort Smith, Inc.

Select Specialty Hospital - Fort Wayne, Inc.

Select Specialty Hospital - Gadsden, Inc.

Select Specialty Hospital - Greensburg, Inc.

Select Specialty Hospital - Honolulu, Inc.

Select Specialty Hospital - Houston, Inc.

Select Specialty Hospital - Huntsville, Inc.

Select Specialty Hospital - Indianapolis, Inc.

Select Specialty Hospital - Jackson, Inc.

Select Specialty Hospital - Johnstown, Inc.

Select Specialty Hospital - Kansas City, Inc.

Select Specialty Hospital - Knoxville, Inc.

Select Specialty Hospital - Lansing, Inc.

Select Specialty Hospital - Lee, Inc.

Select Specialty Hospital - Leon, Inc.

Select Specialty Hospital - Lexington, Inc.

Select Specialty Hospital - Little Rock, Inc.

Select Specialty Hospital - Louisville, Inc.

Select Specialty Hospital - Macomb County, Inc.

Select Specialty Hospital - Macon, Inc.

Select Specialty Hospital - Marion, Inc.

Select Specialty Hospital - Memphis, Inc.

Select Specialty Hospital - Milwaukee, Inc.

Select Specialty Hospital - Morgantown, Inc.

Select Specialty Hospital - Nashville, Inc.

Select Specialty Hospital - New Orleans, Inc.

Select Specialty Hospital - North Knoxville, Inc.

Select Specialty Hospital - Northwest Detroit, Inc.

Select Specialty Hospital - Northwest Indiana, Inc.

<PAGE>

Select Specialty Hospital - Oklahoma City, Inc.

Select Specialty Hospital - Oklahoma City/East Campus, Inc.

Select Specialty Hospital - Omaha, Inc.

Select Specialty Hospital - Orange, Inc.

Select Specialty Hospital - Palm Beach, Inc.

Select Specialty Hospital - Philadelphia/AEMC, Inc.

Select Specialty Hospital - Phoenix, Inc.

Select Specialty Hospital - Pittsburgh, Inc.

Select Specialty Hospital - Pontiac, Inc.

Select Specialty Hospital - Reno, Inc.

Select Specialty Hospital - Saginow, Inc.

Select Specialty Hospital - San Antonio, Inc.

Select Specialty Hospital - Sarasota, Inc.

Select Specialty Hospital - Sioux Falls, Inc.

Select Specialty Hospital - South Dallas, Inc.

Select Specialty Hospital - Topeka, Inc.

Select Specialty Hospital - TriCities, Inc.

Select Specialty Hospital - Tulsa, Inc.

Select Specialty Hospital - Western Michigan, Inc.

Select Specialty Hospital - Western Missouri, Inc.

Select Specialty Hospital - Wichita, Inc.

Select Specialty Hospital - Wilmington, Inc.

Select Specialty Hospital - Wyandotte, Inc.

Select Specialty Hospital - Youngstown, Inc.

Select Specialty Hospital - Zanesville, Inc.

Select Specialty Hospitals, Inc.

Select Synergos, Inc.

Select Transport, Inc.

Select Unit Management, Inc.

SLMC Finance Corporation

South Jersey Physical Therapy Associates, Inc.

<PAGE>

South Jersey Rehabilitation and Sports Medicine Center, Inc.

South Philadelphia Occupational Health, Inc.

Southpointe Fitness Center, Inc.

Southwest Emergency Associates, Inc.

Southwest Physical Therapy, Inc.

Southwest Therapists, Inc.

Sports & Orthopedic Rehabilitation Services, Inc.

Sports Therapy and Arthritis Rehabilitation, Inc.

Star Physical Therapy, Inc.

Stephenson-Holtz, Inc.

The Center for Physical Therapy and Rehabilitation, Inc.

The Orthopedic Sports and Industrial Rehabilitation Network, Inc.

TJ Partnership I

Treister, Inc.

Valley Group Physical Therapists, Inc.

Vanguard Rehabilitation, Inc.

Victoria Healthcare, Inc.

Wayzata Physical Therapy Center, Inc.

West Penn Rehabilitation Services, Inc.

West Side Physical Therapy, Inc.

West Suburban Health Partners, Inc.

Yuma Rehabilitation Center, Inc.

<PAGE>

                                                                         ANNEX A

                  Each broker-dealer that receives Exchange Securities for its
own account pursuant to the Registered Exchange Offer must acknowledge that it
will deliver a prospectus in connection with any resale of such Exchange
Securities. The Letter of Transmittal states that by so acknowledging and by
delivering a prospectus, a broker-dealer will not be deemed to admit that it is
an "underwriter" within the meaning of the Securities Act. This Prospectus, as
it may be amended or supplemented from time to time, may be used by a
broker-dealer in connection with resales of Exchange Securities received in
exchange for Securities where such Securities were acquired by such
broker-dealer as a result of market-making activities or other trading
activities. The Company has agreed that, for a period of 180 days after the
Expiration Date (as defined herein), it will make this Prospectus available to
any broker-dealer for use in connection with any such resale. See "Plan of
Distribution"

<PAGE>

                                                                         ANNEX B

                  Each broker-dealer that receives Exchange Securities for its
own account in exchange for Securities, where such Securities were acquired by
such broker-dealer as a result of market-making activities or other trading
activities, must acknowledge that it will deliver a prospectus in connection
with any resale of such Exchange Securities. See "Plan of Distribution".

<PAGE>

                                                                         ANNEX C

                              PLAN OF DISTRIBUTION

                  Each broker-dealer that receives Exchange Securities for its
own account pursuant to the Registered Exchange Offer must acknowledge that it
will deliver a prospectus in connection with any resale of such Exchange
Securities. This Prospectus, as it may be amended or supplemented from time to
time, may be used by a broker-dealer in connection with resales of Exchange
Securities received in exchange for Securities where such Securities were
acquired as a result of market-making activities or other trading activities.
The Company and the Guarantors have agreed that, for a period of 180 days after
the Expiration Date, they will make this prospectus, as amended or supplemented,
available to any broker-dealer for use in connection with any such resale. In
addition, until _______________, 200_, all dealers effecting transactions in the
Exchange Securities may be required to deliver a prospectus.

                  The Company and the Guarantors will not receive any proceeds
from any sale of Exchange Securities by broker-dealers. Exchange Securities
received by broker-dealers for their own account pursuant to the Registered
Exchange Offer may be sold from time to time in one or more transactions in the
over-the-counter market, in negotiated transactions, through the writing of
options on the Exchange Securities or a combination of such methods of resale,
at market prices prevailing at the time of resale, at prices related to such
prevailing market prices or at negotiated prices. Any such resale may be made
directly to purchasers or to or through brokers or dealers who may receive
compensation in the form of commissions or concessions from any such
broker-dealer or the purchasers of any such Exchange Securities. Any
broker-dealer that resells Exchange Securities that were received by it for its
own account pursuant to the Registered Exchange Offer and any broker or dealer
that participates in a distribution of such Exchange Securities may be deemed to
be an "underwriter" within the meaning of the Securities Act and any profit on
any such resale of Exchange Securities and any commission or concessions
received by any such persons may be deemed to be underwriting compensation under
the Securities Act. The Letter of Transmittal states that, by acknowledging that
it will deliver and by delivering a prospectus, a broker-dealer will not be
deemed to admit that it is an "underwriter" within the meaning of the Securities
Act.

                  For a period of 180 days after the Expiration Date the Company
and the Guarantors will promptly send additional copies of this Prospectus and
any amendment or supplement to this Prospectus to any broker-dealer that
requests such documents in the Letter of Transmittal. The Company and the
Guarantors have agreed to pay all expenses incident to the Registered Exchange
Offer (including the expenses of one counsel for the Holders of the Securities)
other than commissions or concessions of any broker-dealers and will indemnify
the Holders of the Securities (including any broker-dealers) against certain
liabilities, including liabilities under the Securities Act.

<PAGE>

                                                                         ANNEX D

                  CHECK HERE IF YOU ARE A BROKER-DEALER AND WISH TO RECEIVE 10
                  ADDITIONAL COPIES OF THE PROSPECTUS AND 10 COPIES OF ANY
                  AMENDMENTS OR SUPPLEMENTS THERETO.

                  Name:
                  Address:

If the undersigned is not a broker-dealer, the undersigned represents that it is
not engaged in, and does not intend to engage in, a distribution of Exchange
Securities. If the undersigned is a broker-dealer that will receive Exchange
Securities for its own account in exchange for Securities that were acquired as
a result of market-making activities or other trading activities, it
acknowledges that it will deliver a prospectus in connection with any resale of
such Exchange Securities; however, by so acknowledging and by delivering a
prospectus, the undersigned will not be deemed to admit that it is an
"underwriter" within the meaning of the Securities Act.<PAGE>
                                                                     EXHIBIT 4.7

                             SUPPLEMENTAL INDENTURE

                  SUPPLEMENTAL INDENTURE, dated as of September 2, 2003, among
Select Medical Corporation, a Delaware corporation ("Select"), the subsidiary
guarantors listed on Schedule I and Schedule II hereto (the "Subsidiary
Guarantors"), Select Medical Escrow, Inc., a Delaware corporation ("Select
Medical Escrow") and U.S. Bank Trust National Association, as trustee under the
Indenture referred to below (the "Trustee").

                              W I T N E S S E T H:

                  WHEREAS, Select Medical Escrow and the Trustee heretofore
executed and delivered an Indenture, dated as of August 12, 2003 (as amended,
supplemented, waived or otherwise modified, the "Indenture"), providing for the
issuance of the 7-1/2% Senior Subordinated Notes due 2013 (the "Securities,");

                  WHEREAS, Section 501 of the Indenture provides that upon the
execution and delivery by Select to the Trustee of this Supplemental Indenture,
Select shall be the successor Company under the Indenture and the Securities and
shall succeed to, and be substituted for, and may exercise every right and power
of, Select Medical Escrow under the Indenture and the Securities and Select
Medical Escrow shall be discharged from all obligations and covenants under the
Indenture and the Securities;

                  WHEREAS, pursuant to the Indenture, upon execution and
delivery by the Subsidiary Guarantors to the Trustee of this Supplemental
Indenture, the Subsidiary Guarantors shall be the Subsidiary Guarantors under
and as defined in the Indenture and the Securities;

                  WHEREAS, each Subsidiary Guarantor desires to enter into this
Supplemental Indenture for good and valuable consideration, including
substantial economic benefit in that the financial performance and condition of
each of the Subsidiary Guarantors is dependent on the financial performance and
condition of the Company and on each such Subsidiary Guarantor's access to
working capital through the Company's access to revolving credit borrowings
under the Senior Credit Agreement;

                  WHEREAS, pursuant to Section 901 of the Indenture, the parties
hereto are authorized to execute and deliver this Supplemental Indenture to
amend the Indenture, without the consent of any Holder;
<PAGE>
                  WHEREAS, this Supplemental Indenture has been duly authorized
by all necessary corporate action on the part of each of Select, each of the
Subsidiary Guarantors and Select Medical Escrow.

                  NOW, THEREFORE, in consideration of the premises and for other
good and valuable consideration, the receipt of which is hereby acknowledged,
Select, each of the Subsidiary Guarantors, Select Medical Escrow and the Trustee
mutually covenant and agree for the benefit of the Holders of the Notes as
follows:

                  1. Defined Terms. As used in this Supplemental Indenture,
terms defined in the Indenture or in the preamble or recital hereto are used
herein as therein defined. The words "herein," "hereof" and "hereby" and other
words of similar import used in this Supplemental Indenture refer to this
Supplemental Indenture as a whole and not to any particular section hereof.

                  2. Assumption of the Securities. Select hereby expressly
assumes and agrees promptly to pay, perform and discharge when due each and
every debt, obligation, covenant and agreement incurred, made or to be paid,
performed or discharged by Select Medical Escrow under the Indenture and the
Securities. Select hereby agrees to be bound by all the terms, provisions and
conditions of the Indenture and the Securities and that it shall be the
successor Company and shall succeed to, and be substituted for, and may exercise
every right and power of, Select Medical Escrow, as the predecessor Company,
under the Indenture and the Securities. The Subsidiary Guarantors hereby agree
to guarantee the obligations of Select being assumed pursuant to the terms of
this Supplemental Indenture.

                  3. Discharge of Select Medical Escrow. Select Medical Escrow
is hereby expressly discharged from all debts, obligations, covenants and
agreements under the Indenture and the Securities.

                  4. Agreement to Subsidiary Guarantee. Each Subsidiary
Guarantor hereby agrees, jointly and severally with all other Subsidiary
Guarantors, fully and unconditionally, to guarantee the Guaranteed Obligations
under the Indenture and the Securities on the terms and subject to the
conditions set forth in Article Thirteen of the Indenture and to be bound by
(and shall be entitled to the benefits of) all other applicable provisions of
the Indenture as a Subsidiary Guarantor. The Subsidiary Guarantee of each
Subsidiary Guarantor is subject to the subordination provisions of the
Indenture.

                  5. Termination, Release and Discharge. Each Subsidiary
Guarantor's Subsidiary Guarantee shall terminate and be of no further force or
effect, and each Subsidiary Guarantor shall be released and discharged from all
obligations in respect of such Subsidiary Guarantee, as and when provided in
Section 1303 of the Indenture.
<PAGE>
                  6. Parties. Nothing in this Supplemental Indenture is intended
or shall be construed to give any Person, other than the Holders and the
Trustee, any legal or equitable right, remedy or claim under or in respect of
each Subsidiary Guarantor's Subsidiary Guarantee or any provision contained
herein or in Article Thirteen of the Indenture.

                  7. Governing Law. THIS SUPPLEMENTAL INDENTURE SHALL BE
GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW
YORK. THE TRUSTEE, SELECT, SELECT MEDICAL ESCROW, EACH SUBSIDIARY GUARANTOR, ANY
OTHER OBLIGOR IN RESPECT OF THE NOTES AND (BY THEIR ACCEPTANCE OF THE NOTES) THE
HOLDERS, AGREE TO SUBMIT TO THE JURISDICTION OF ANY UNITED STATES FEDERAL OR
STATE COURT LOCATED IN THE BOROUGH OF MANHATTAN, IN THE CITY OF NEW YORK IN ANY
ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS INDENTURE OR THE NOTES.

                  8. Ratification of Indenture; Supplemental Indentures Part of
Indenture. Except as expressly amended hereby, the Indenture is in all respects
ratified and confirmed and all the terms, conditions and provisions thereof
shall remain in full force and effect. This Supplemental Indenture shall form a
part of the Indenture for all purposes, and every Holder of Notes heretofore or
hereafter authenticated and delivered shall be bound hereby. This Supplemental
Indenture is an indenture supplemental to and in implementation of the
Indenture, and the Indenture and this Supplemental Indenture shall henceforth be
read and construed together. The Trustee makes no representation or warranty as
to the validity or sufficiency of this Supplemental Indenture.

                  9. Counterparts. The parties hereto may sign one or more
copies of this Supplemental Indenture in counterparts, all of which together
shall constitute one and the same agreement.

                  10. Headings. The section headings herein are for convenience
of reference only and shall not be deemed to alter or affect the meaning or
interpretation of any provisions hereof.

                  11. Trustee's Acceptance. The Trustee hereby accepts this
Supplemental Indenture and agrees to perform the same under the terms and
conditions set forth in the Indenture.

                  12. Conflict with Trust Indenture Act. If any provision of
this Supplemental Indenture limits, qualifies or conflicts with any provision of
the TIA that is required under the TIA to be part of and govern any provision of
this Supplemental Indenture, the provision of the TIA shall control. If any
provision of this Supplemental Indenture modifies or excludes any provision of
the TIA that may be so modified or
<PAGE>
excluded, the provision of the TIA shall be deemed to apply to the Indenture as
so modified or to be excluded by this Supplemental Indenture, as the case may
be.

                  13. Severability. In case any provision in this Supplemental
Indenture shall be invalid, illegal or unenforceable, the validity, legality and
enforceability of the remaining provisions shall not in any way be affected or
impaired thereby.

                  14. Successors. All agreements of Select in this Supplemental
Indenture shall bind its successors. All agreements of the Trustee in this
Supplemental Indenture shall bind its successors.

                  15. Certain Duties and Responsibilities of the Trustee. In
entering into this Supplemental Indenture, the Trustee shall be entitled to the
benefit of every provision of the Indenture and the Securities relating to the
conduct or affecting the liability or affording protection to the Trustee,
whether or not elsewhere herein so provided.
<PAGE>
                  IN WITNESS WHEREOF, the parties hereto have caused this
Supplemental Indenture to be duly executed as of the date first written above.

                                   SELECT MEDICAL CORPORATION

                                   By:    /s/  Michael E. Tarvin
                                        ---------------------------------------
                                        Name:  Michael E. Tarvin
                                        Title: Senior Vice President

                                   SELECT MEDICAL ESCROW, INC.

                                   By:    /s/  Michael E. Tarvin
                                        ---------------------------------------
                                        Name:  Michael E. Tarvin
                                        Title: Vice President

                                   U.S. BANK TRUST NATIONAL ASSOCIATION, as
                                   Trustee

                                   By:    /s/  Jean Clarke
                                        ---------------------------------------
                                        Name:  Jean Clarke
                                        Title: Assistant Vice President

                                   SUBSIDIARY GUARANTORS:

                                   EACH SUBSIDIARY GUARANTOR LISTED ON SCHEDULE
                                   I HERETO

                                   By:    /s/  Michael E. Tarvin
                                        ---------------------------------------
                                        Name:  Michael E. Tarvin
                                        Title: Vice President
<PAGE>
                                   EACH SUBSIDIARY GUARANTOR LISTED ON SCHEDULE
                                   II HERETO

                                   By:    /s/  Michael E. Tarvin
                                        ---------------------------------------
                                        Name:  Michael E. Tarvin
                                        Title: Vice President
<PAGE>
                                                                      Schedule I

                              SUBSIDIARY GUARANTORS

Affiliated Physical Therapists, Ltd.

Allegany Hearing and Speech, Inc.

American Transitional Hospitals, Inc.

Athens Sports Medicine Clinic, Inc.

Ather Sports Injury Clinic, Inc.

Atlantic Health Group, Inc.

Atlantic Rehabilitation Services, Inc.

Avalon Rehabilitation & Healthcare, LLC

Buendel Physical Therapy, Inc.

C.E.R. - West, Inc.

C.O.A.S.T. Institute Physical Therapy, Inc.

CCISUB, Inc.

Cenla Physical Therapy & Rehabilitation Agency, Inc.

Center for Evaluation & Rehabilitation, Inc.

Center for Physical Therapy & Sports Rehabilitation, Inc.

CenterTherapy, Inc.

Champion Physical Therapy, Inc.

Coplin Physical Therapy Associates, Inc.

Crowley Physical Therapy Clinic, Inc.

Douglas Avery & Associates, Ltd.

Elk County Physical Therapy, Inc.

Fine, Bryant & Wah, Inc.

Francis Naselli, Jr. & Stewart Rich Physical Therapists, Inc.

Gallery Physical Therapy Center, Inc.

Georgia Physical Therapy of West Georgia, Inc.

Georgia Physical Therapy, Inc.

GP Therapy, L.L.C.

Greater Sacramento Physical Therapy Associates, Inc.

Grove City Physical Therapy and Sports Medicine, Inc.
<PAGE>
                                                                      Schedule I

Gulf Breeze Physical Therapy, Inc.

Hand Therapy Associates, Inc.

Hand Therapy and Rehabilitation Associates, Inc.

Hangtown Physical Therapy, Inc.

Hawley Physical Therapy, Inc.

Hudson Physical Therapy Services, Inc.

Human Performance and Fitness, Inc.

Indianapolis Physical Therapy and Sports Medicine, Inc.

Intensiva Healthcare Corporation

Intensiva Hospital of Greater St. Louis, Inc.

Joyner Sports Science Institute, Inc.

Joyner Sportsmedicine Institute, Inc.

Kentucky Rehabilitation Services, Inc.

Lynn M. Carlson, Inc.

Metro Rehabilitation Services, Inc.

Michigan Therapy Centre, Inc.

MidAtlantic Health Group, Inc.

Monmouth Rehabilitation, Inc.

New England Health Group, Inc.

New Mexico Physical Therapists, Inc.

Northside Physical Therapy, Inc.

NovaCare Health Group, LLC

NovaCare Occupational Health Services, Inc.

NovaCare Outpatient Rehabilitation East, Inc.

NovaCare Outpatient Rehabilitation, Inc.

NovaCare Outpatient Rehabilitation of California, Inc.

NovaCare Outpatient Rehabilitation West, Inc.

NovaCare Rehabilitation, Inc.

NW Rehabilitation Associates, Inc.

P.T. Services Company
<PAGE>
                                                                      Schedule I

P.T. Services, Inc.

P.T. Services Rehabilitation, Inc.

Peter Trailov R.P.T. Physical Therapy Clinic, Orthopedic Rehabilitation & Sports
Medicine, Ltd.

Physical Rehabilitation Partners, Inc.

Physical Therapy Enterprises, Inc.

Physical Therapy Institute, Inc.

Physical Therapy Services of the Jersey Cape, Inc.

Physio - Associates, Inc.

Pro Active Therapy, Inc.

Pro Active Therapy of Ahoskie, Inc.

Pro Active Therapy of Gaffney, Inc.

Pro Active Therapy of Greenville, Inc.

Pro Active Therapy of North Carolina, Inc.

Pro Active Therapy of Rocky Mount, Inc.

Pro Active Therapy of South Carolina, Inc.

Pro Active Therapy of Virginia, Inc.

Professional Therapeutic Services, Inc.

Quad City Management, Inc.

RCI (Colorado), Inc.

RCI (Exertec), Inc.

RCI (Michigan), Inc.

RCI (S.P.O.R.T.), Inc.

RCI (WRS), Inc.

Rebound Oklahoma, Inc.

Redwood Pacific Therapies, Inc.

Rehab Advantage, Inc.

Rehab Managed Care of Arizona, Inc.

Rehab Provider Network - California, Inc.

Rehab Provider Network - East I, Inc.

Rehab Provider Network - East II, Inc.
<PAGE>
                                                                      Schedule I

Rehab Provider Network - Georgia, Inc.

Rehab Provider Network - Indiana, Inc.

Rehab Provider Network - Michigan, Inc.

Rehab Provider Network - New Jersey, Inc.

Rehab Provider Network - Ohio, Inc.

Rehab Provider Network - Oklahoma, Inc.

Rehab Provider Network - Pennsylvania, Inc.

Rehab Provider Network - Washington, D.C., Inc.

Rehab Provider Network of Colorado, Inc.

Rehab Provider Network of Florida, Inc.

Rehab Provider Network of Nevada, Inc.

Rehab Provider Network of New Mexico, Inc.

Rehab Provider Network of North Carolina, Inc.

Rehab Provider Network of Texas, Inc.

Rehab Provider Network of Wisconsin, Inc.

Rehab/Work Hardening Management Associates, Ltd.

RehabClinics, Inc.

RehabClinics (GALAXY), Inc.

RehabClinics (PTA), Inc.

RehabClinics (SPT), Inc.

RehabClinics Abilene, Inc.

RehabClinics Dallas, Inc.

RehabClinics Pennsylvania, Inc.

S.T.A.R.T., Inc.

Select Air II, Inc.

Select Employment Services, Inc.

Select Hospital Investors, Inc.

Select Management Services, LLC

SelectMark, Inc.

Select Medical of Kentucky, Inc.
<PAGE>
                                                                      Schedule I

Select Medical of Maryland, Inc.

Select Medical of New Jersey, Inc.

Select Medical of New York, Inc.

Select Medical of Ohio, Inc.

Select Medical of Pennsylvania, Inc.

Select Medical Rehabilitation Clinics, Inc.

Select Provider Networks, Inc.

Select Rehabilitation Management Services, Inc.

Select Software Ventures, LLC

Select Specialty Hospital - Akron, Inc.

Select Specialty Hospital - Albuquerque, Inc.

Select Specialty Hospital - Ann Arbor, Inc.

Select Specialty Hospital - Arizona, Inc.

Select Specialty Hospital - Battle Creek, Inc.

Select Specialty Hospital - Beech Grove, Inc.

Select Specialty Hospital - Bloomington, Inc.

Select Specialty Hospital - Boston, Inc.

Select Specialty Hospital - Central Detroit, Inc.

Select Specialty Hospital - Charleston, Inc.

Select Specialty Hospital - Cincinnati, Inc.

Select Specialty Hospital - Columbus, Inc.

Select Specialty Hospital - Columbus/Grant, Inc.

Select Specialty Hospital - Columbus/University, Inc.

Select Specialty Hospital - Conroe, Inc.

Select Specialty Hospital - Dallas, Inc.

Select Specialty Hospital - Denver, Inc.

Select Specialty Hospital - Durham, Inc.

Select Specialty Hospital - Erie, Inc.

Select Specialty Hospital - Escambia, Inc.

Select Specialty Hospital - Evansville, Inc.
<PAGE>
                                                                      Schedule I

Select Specialty Hospital - Flint, Inc.

Select Specialty Hospital - Fort Smith, Inc.

Select Specialty Hospital - Fort Wayne, Inc.

Select Specialty Hospital - Gadsden, Inc.

Select Specialty Hospital - Greensburg, Inc.

Select Specialty Hospital - Honolulu, Inc.

Select Specialty Hospital - Houston, Inc.

Select Specialty Hospital - Huntsville, Inc.

Select Specialty Hospital - Indianapolis, Inc.

Select Specialty Hospital - Jackson, Inc.

Select Specialty Hospital - Johnstown, Inc.

Select Specialty Hospital - Kansas City, Inc.

Select Specialty Hospital - Knoxville, Inc.

Select Specialty Hospital - Lansing, Inc.

Select Specialty Hospital - Lee, Inc.

Select Specialty Hospital - Leon, Inc.

Select Specialty Hospital - Lexington, Inc.

Select Specialty Hospital - Little Rock, Inc.

Select Specialty Hospital - Louisville, Inc.

Select Specialty Hospital - Macomb County, Inc.

Select Specialty Hospital - Macon, Inc.

Select Specialty Hospital - Marion, Inc.

Select Specialty Hospital - Memphis, Inc.

Select Specialty Hospital - Milwaukee, Inc.

Select Specialty Hospital - Morgantown, Inc.

Select Specialty Hospital - Nashville, Inc.

Select Specialty Hospital - New Orleans, Inc.

Select Specialty Hospital - North Knoxville, Inc.

Select Specialty Hospital - Northwest Detroit, Inc.

Select Specialty Hospital - Northwest Indiana, Inc.
<PAGE>
                                                                      Schedule I

Select Specialty Hospital - Oklahoma City, Inc.

Select Specialty Hospital - Oklahoma City/East Campus, Inc.

Select Specialty Hospital - Omaha, Inc.

Select Specialty Hospital - Orange, Inc.

Select Specialty Hospital - Palm Beach, Inc.

Select Specialty Hospital - Philadelphia/AEMC, Inc.

Select Specialty Hospital - Phoenix, Inc.

Select Specialty Hospital - Pittsburgh, Inc.

Select Specialty Hospital - Pontiac, Inc.

Select Specialty Hospital - Reno, Inc.

Select Specialty Hospital - Saginaw, Inc.

Select Specialty Hospital - San Antonio, Inc.

Select Specialty Hospital - Sarasota, Inc.

Select Specialty Hospital - Sioux Falls, Inc.

Select Specialty Hospital - South Dallas, Inc.

Select Specialty Hospital - Topeka, Inc.

Select Specialty Hospital - TriCities, Inc.

Select Specialty Hospital - Tulsa, Inc.

Select Specialty Hospital - Western Michigan, Inc.

Select Specialty Hospital - Western Missouri, Inc.

Select Specialty Hospital - Wichita, Inc.

Select Specialty Hospital - Wilmington, Inc.

Select Specialty Hospital - Wyandotte, Inc.

Select Specialty Hospital - Youngstown, Inc.

Select Specialty Hospital - Zanesville, Inc.

Select Specialty Hospitals, Inc.

Select Synergos, Inc.

Select Transport, Inc.

Select Unit Management, Inc.

SLMC Finance Corporation
<PAGE>
                                                                      Schedule I

South Jersey Physical Therapy Associates, Inc.

South Jersey Rehabilitation and Sports Medicine Center, Inc.

South Philadelphia Occupational Health, Inc.

Southpointe Fitness Center, Inc.

Southwest Emergency Associates, Inc.

Southwest Physical Therapy, Inc.

Southwest Therapists, Inc.

Sports & Orthopedic Rehabilitation Services, Inc.

Stephenson-Holtz, Inc.

The Center for Physical Therapy and Rehabilitation, Inc.

The Orthopedic Sports and Industrial Rehabilitation Network, Inc.

TJ Partnership I

Treister, Inc.

Valley Group Physical Therapists, Inc.

Vanguard Rehabilitation, Inc.

Victoria Healthcare, Inc.

Wayzata Physical Therapy Center, Inc.

West Penn Rehabilitation Services, Inc.

West Side Physical Therapy, Inc.

West Suburban Health Partners, Inc.

Yuma Rehabilitation Center, Inc.
<PAGE>
                                                                     Schedule II

                               KESSLER GUARANTORS

Kessler Rehabilitation Corporation

Argosy Health, LLC

Atra Services, Inc.

Community Rehab Centers of Massachusetts, Inc.

Core Rehab Management, LLC

CRF Rehabilitation Associates, Inc.

Edgewater Rehabilitation Associates, Inc.

Horizon Health & Rehabilitation, Inc.

Kessler Assisted Living Corporation

Kessler Care Center at Cedar Grove, Inc.

Kessler Care Center at Great Falls, Inc. (dissolution pending)

Kessler Care Center at St. Cloud, Inc. (dissolution pending)

Kessler Institute for Rehabilitation, Inc.

Kessler Occupational Medicine Centers, Inc.

Kessler Physical Therapy & Rehabilitation, Inc.

Kessler Rehab Centers, Inc.

Kessler Rehab of Connecticut, Inc.

Kessler Rehabilitation of Florida, Inc.

Kessler Rehabilitation of Maryland, Inc.

Kessler Rehabilitation Services, Inc.

Pennsylvania Rehab, Inc.

Physical Therapy Associates, Inc.

Wilpage, Inc.

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