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Able Faith Application

Thank You for Your Interest in Able Faith!

Able Faith is a donor-funded, volunteer-driven nonprofit serving individuals living with neurological disabilities—such as paralysis from spinal cord injuries, strokes, or multiple sclerosis—and the people who support them. Our mission is to create a supportive community where individuals can grow stronger, more independent, and more connected

Before You Begin
Our team of neuro-exercise specialists is here to help you move safely and confidently. While we offer expert guidance, our programs are not medically supervised or therapy-based.

We recommend consulting with your healthcare provider before starting any new fitness program. Please notify us of any health conditions or physical limitations not covered in the form.

Membership Eligibility Criteria
Able Faith Adaptive Gym & Community Center exists to serve individuals with neuromuscular disabilities and related mobility impairments. To ensure safety, effectiveness, and a supportive community environment, applicants must meet the following criteria:

  • Diagnosis: A neuromuscular disability, spinal cord injury, paralysis, or similar condition affecting movement, motor control, or mobility. This includes, but is not limited to:

    • Spinal Cord Injury (SCI)

    • Stroke (Cerebrovascular Accident)

    • Traumatic Brain Injury (TBI)

    • Cerebral Palsy (CP)

    • Multiple Sclerosis (MS)

    • Muscular Dystrophy

    • Guillain-Barré Syndrome

    • Spina Bifida

    • Amyotrophic Lateral Sclerosis (ALS)

    • Parkinson’s Disease

    • Other progressive or acquired neuromuscular disorders

  • Independence with Basic Needs: Applicants must be independent with basic tasks such as eating, toileting, and transfers—or be accompanied by a caregiver who can assist as needed.

  • Community Readiness: Members must be willing to participate in a respectful, inclusive community atmosphere and follow all safety and conduct guidelines.

  • Transportation: Participants are responsible for their own transportation to and from the facility.

Application Review & Next Steps
Once your application is submitted, please allow 7–10 business days for review.
If approved, you will receive a membership form and participation waiver via email to complete before beginning any programs or services.

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First Name *
Last Name *
Email Address *
Phone Number *
Date of Birth *
MM
/
DD
/
YYYY
Zip Code *
Describe your disability or diagnosis *
Date  of Injury or Diagnosis *
MM
/
DD
/
YYYY
Do you have any secondary conditions we should be aware of ( seizures, spasticity, autonomic dysreflexia) *
Do you have Significant Hearing or Vision Impairment *
Required
If Yes Above, Please describe the level or impairment and what accommodations you typically use
Do you have any spinal hardware (i.e., plates, rods, cages, wires, spacers, hooks, and screws)? *
Check all the programs you’re interested in:
 *
Required
Can you provide Documentation of physician release to participate in an adaptive exercise program? *
How would you describe your mobility? *
Are you currently receiving therapy?
(physical, occupational, speech, etc)
 *
Is the Applicant Insured? *
Insurance Company
Does the Applicant have medicare/medicaid? *
Does the Applicant receive Disability? *
Is the Applicant a Veteran? *
Do you have transportation to the Able Faith Center? (Able Faith DOES NOT provide transportation.) *
What level of physical assistance, if any, do you typically require while participating in physical activities or using gym equipment? *
Will you be coming with a family member or caregiver, or on your own? *
Are you able to use the restroom independently without assistance? (Please note that Able Faith staff are not able to provide toileting or personal care assistance.)
 *
What are your main goals for joining our community? *
Required
Briefly describe your short and long term goals in joining our community. *
How did you hear about Able Faith?
Please be specific (name of person, therapist, hospital, organization, or platform).
 *
What is your approximate annual household income? 
Used only for demographic reporting and grant purposes. *
How many people live in your household? 
Please include yourself and anyone financially supported by the household. *
Is there any other information you think would be helpful for us to know in order to best support you?
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