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Advocate Good Samaritan Health and Wellness Center, on the hospital campus; 3551 Highland Avenue, Downers Grove, Illinois 60515 Phone: 630.275.2879; Fax: 630.275.2650; www.advocatehealth.com/goodsam/wellness
Use the print button located on the page at the upper left to print out this handout; obtain your doctor's approval to exercise at the Wellness Center.
What is Dr. Fit? The  program at Good Samaritan Health and Wellness Center is a 30-day program designed to address your needs and wants in conjunction with your physician’s recommendations. Learn the basics of a successful fitness program including goal setting, safety and progression. Gain the tools, knowledge, motivation and support you need to succeed in a fitness and wellness program.
What do I receive?
- Full membership privileges
- One (1) group orientation and goal-setting session
- Eight (8) group workout sessions with a degreed fitness professional
- Additional motivation and goal-setting classes through the Wellness Center 101 lecture series
- Access to 80 free classes a week
- 30 days for only $50
- Join before your 30-day membership expires and we will waive your activation fee.
How do you get started? Talk to your doctor about your participation in this program. Ask your doctor to complete the Physician Approval section on page 2. Register by calling Member Services at 630.275.2879.
When do new sessions begin? New sessions begin every Monday evening, 6:00pm - 7:00pm, at the Good Samaritan Health and Wellness Center, or as determined by your needs. Group workout appointments will be determined at Monday's orientation session based on the needs of the participants.
Who do you call for more information? Call the Good Samaritan Health and Wellness Center Member Services office at 630.275.2879 with any questions and to make an appointment for a complimentary tour before your first Dr. Fit session.
What makes the Wellness Center different from any other fitness center in the area? It's our commitment to the medical model of fitness. The Wellness Center's fitness staff are fitness professionals with college degrees in exercise science-related fields, backed by the guidance, expertise and quality of Advocate Good Samaritan Hospital. When talking with any of our professional staff, you can be assured that our staff are making exercise recommendations based on the most current exercise science research and guidelines. Read more about the medical model of fitness on our website at www.advocatehealth.com/gsam/medical-model.
 Please complete this form with your name and contact information. Ask your doctor to sign the physician approval section and fax this page to the Wellness Center.
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Patient Name:
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Phone:
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______________________________________________________ |
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Email:
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Physician's exercise recommendations and approval to exercise. Please check the appropriate risk assessment below. I consider this patient to be:
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Low risk: presumably healthy without apparent cardiovascular disease and no more than one risk factor for CAD.
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Moderate risk: presumably healthy without apparent cardiovascular disease, and two or more risk factors for CAD.
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High risk: with one or more signs/symptoms suggestive of, or with know cardiovascular, pulmonary, or metabolic disease.
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Do you have any exercise recommendations or does your patient have any limitations that need to be considered?
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This patient is approved for participation in an exercise program at the Good Samaritan Health and Wellness Center.
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Physician Signature:
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______________________________________________________ |
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Print Name:
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______________________________________________________ |
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Date:
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Doctor, please FAX completed form to the Wellness Center at 630.275.2650.
Advocate Good Samaritan Health and Wellness Center, located on the hospital campus; 3551 Highland Avenue, Downers Grove, Illinois 60515 Phone: 630.275.2879; Fax: 630.275.2650; www.advocatehealth.com/goodsam/wellness/ |
