EnhanceFitness - Participant Online Application  (2018)

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Aloha! 


Get ready to experience a positive transformation in your overall health! Welcome to EnhanceFitness®, a new program of St. Francis Healthcare System. 


Creating Healthy Communities…Starting with You! St. Francis Healthcare System’s mission is to enhance the quality of life for everyone in the community — for those of all ages. It’s never too early or too late to start to experience results. That’s why we’re excited to introduce EnhanceFitness® for the residents of Franciscan Vistas Ewa. This physical activity program changes lives and is another great free benefit for Franciscan Vistas Ewa residents! 


Improving Your Health Studies show regular physical activity improves overall health, memory, mood, balance, bone density, endurance, flexibility, and coordination. The sessions are designed to improve your physical conditioning and to decrease your risk of falling. We think you will be pleasantly surprised by how much better you will feel by participating in this program. 


Personalized Coaching As your instructor, I will help you get the most out of this simple yet effective program. If you are currently inactive, you may experience a little muscle soreness at first. To counteract this common response when starting a new form of exercise, we encourage you to attend class on a regular basis, start gently, and increase your intensity gradually. 


Recommended Attire Wear comfortable clothing and supportive, closed toe shoes to class. A couple of class guidelines are: 

 Go at your own pace 

 Never do anything that hurts 

 If your doctor says don’t do it, please don’t do it 


Exercise Schedule This hour-long class is held three days a week. We’ll meet in Franciscan Vistas Ewa’s Community Center every Monday, Wednesday, and Friday, from 10:30 am to 11:30 am. I will be available a few minutes both before and after each class, so please do not hesitate to ask questions. I look forward to exercising with you and getting to know you. 


Sincerely, 


Patricia Baker 


Patricia Baker 

Director, Quality of Life Programs/EnhanceFitness® Instructor 
St. Francis Healthcare System of Hawaii 
Phone: (808) 547-8094 
Email: pbaker@stfrancishawaii.org
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ATTENDANCE GUIDELINES: 


In an effort to address absences in the EnhanceFitness program at each site and address the waitlists (seniors waiting to get into the program), the following guidelines will be in place: 


The Program Coordinator will contact those who are absent to follow-up on the reasons for absences. If you are unable to return to class and a waitlist exists for that class, you will be given the opportunity to be put on the waitlist. Follow-up will be done by mail if we are unable to make telephone contact with you. 


1) Chronic absences 


Minimum attendance to remain in the program is 8 classes a month. Excused absences will be granted at the instructor’s discretion. If you do not meet the minimum attendance requirement, you will be removed from the active roster and will be given the opportunity to be waitlisted. 


2) Vacations 


If you are absent for more than a month, you may be removed from the active roster and given the opportunity to go on the waitlist. 


3) Hospitalization/long term illness 


We believe that returning to EnhanceFitness after a hospitalization/illness/surgery will help with your recovery. Your space will be held for 6 weeks. If you are not able to return within the 6 weeks, you will go to the top of the waitlist and will be notified by the Program Coordinator when an opening is available. You will need to have a doctor’s clearance to assure that you are healthy enough to return to the program. 

If an opening occurs and you are not yet able to return, you will remain at the top of the list and the next person will be contacted. 

It is your responsibility to keep the instructor or Program Coordinator informed of vacations or long absences. 

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Marketing Consent and Authorization Form 


I give consent to St. Francis Healthcare System to take or use images (photographs or videotape) or sound recordings of me and my family members for marketing in any public media, including radio, television, internet or print, or for use in a St. Francis Healthcare System printed or online publication, website or social media tool. I understand that the intended use of such images and is to specifically to promote the quality of care at St. Francis Hospice for marketing purposes. 


I understand that no confidential information about the family or patient will be disclosed. Confidential information includes information obtained from interviews with family, physicians and healthcare staff or from the patient’s medical records, including photographs, x-rays, videotapes and results of diagnostic studies. 


I acknowledge that this consent and authorization is being made solely for the benefit of St. Francis Healthcare System and without any expectation of compensation or other benefits to my family. To the extent that any benefit accrues or might accrue to St. Francis Healthcare System from the use of images or disclosure of information, I forever waive any interest in or claim to such benefits. I hereby release and forever discharge St. Francis Healthcare System (including without limitation all corporate affiliates and officers, directors, employees, staff members and agents) from any and all claims, liability, actions, suits, demands, costs, expenses or indebtedness arising out of, related to, or in any way connected with the use of images or disclosure of the information and materials. 


I understand that this authorization is voluntary and is subject to revocation at any time by notifying St. Francis Healthcare System in writing at: St. Francis Healthcare System, 2226 Liliha St #227, Honolulu, Hawaii 96817. 


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Thank you for taking the time to complete this survey. Please print your answers to the questions on both sides of this form. While you may leave any question blank, we encourage you to complete the survey. Summarized information from all participants will help us demonstrate how this program is serving people who will benefit the most. Your responses are extremely helpful. All your answers will be kept strictly confidential. 

Personal Information













Doctor Information

Doctors listed below will receive an email containing a link to complete an electronic Physician Clearance Form once you submit this application.  It is your responsibility that these forms are submitted.  If they are not received, your application will be considered incomplete. 

If you have any questions, please contact: 

Patricia Baker 
Director, Quality of Life Programs/EnhanceFitness® Instructor 
St. Francis Healthcare System of Hawaii 
Phone: (808) 547-8094 
Email: pbaker@stfrancishawaii.org
Demographic Information