Health & Wellness Appointment Inquiry

Request appointment scheduled for: (Please select one choice only. If additional appointments are desired, please complete an separate submission for each appointment type)

(1 required)

Personal Fitness Consultation	Fitness Assessment	Massage Therapy
Senior Personal Training (1-on-1)	Personal Training (1-on-1)	Small Group Personal Training
Fitness Nutrition Specialist

First and Last Name:

Street Address:

City:

State and Zip:

Email Address:

Phone Number:

Alternate Phone:

Please detail the best dates/times to have your appointment scheduled. Be specific and provide us with two or more options. We will contact you and do our best to accommodate your schedule.

Membership Status (select one):

Member

Non-Member

Thank you for contacting the YMCA of Dodge County! Your emailed appointment request will be routed to the Welcome Center and you should expect a return email within 4 to 8 business hours. Please note that the Welcome Center may not be able to reach our trainers/therapists on the weekend and will have to wait until the next business day to schedule your appointment. Once an appointment time is secured, you will be contacted to confirm if you are able to keep that date and time.

Thank you.

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