Registration

Participant registration

Readiness screening and consent, for adaptive fitness coaching from age 6 through adulthood. It takes about fifteen minutes, and you can move backward and forward before you send it.

Thank you for your interest in Fit Patch Wellness. This form helps us learn about the participant’s abilities, support needs, health considerations, fitness goals, and scheduling preferences.

Completing this form does not guarantee acceptance into a Fit Patch Wellness program. Every prospective participant must complete an evaluation so that we can determine whether we can provide safe and appropriate services within our professional scope.

Step 1 of 14: About you

Section 1Person completing this form

I am completing this form (required)

Your answers stay in this form while it is open. They are only sent to Fit Patch when you press Submit.