Become a Client

Become a Client

  • If you have any completed enrollment forms, please attach them here.
    Drop files here or
    Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

    • Low income clients can receive financial assistance.
      Would you like information?

    • This field is for validation purposes and should be left unchanged.

    Enrollment Forms

    Start your transformation journey at Challenge Center. We work with you to create personalized care from enrollment to completion of the program. Any other forms will be provided once you meet with our team!

    AGEility Class Waiver

    Challenge Center Enrollement Form

    Challenge Center Informed Consent Waiver

    Challenge Center 90-day Scholarship App

    Addendum to Informed Consent/Release of Liability:

    Independent Waiver

    Addendum Informed Consent (EN ESPAÑOL)

    CC Enrollment Form (EN ESPAÑOL)

    CC Independent Client Waiver (EN ESPAÑOL)

    Challenge Center Scholarship Form (EN ESPAÑOL)

    The following forms are available as PDF for you to download and complete. Please either return form to Challenge Center or submit it in the Become a Client form to the left.

    Challenge Center Scholarship Application

    FES Program Physician Release

    Good Faith Estimate

    Notice of Right to Receive a Good Faith Estimate