Join the Sapphire Circle at Swedish Hospital!

Thank you for your interest in Swedish Hospital's Sapphire Circle Club for people aged 60+ residing in the Swedish Hospital community. Sign up to join us for in-person programs and other special events. Membership also includes benefits such as discounts at the Chill Café, Starbucks inside Galter Medical Pavilion and the Galter Life Center.

Please complete this form to register for the Sapphire Circle. Must be at least 60 years of age to join.

If you have questions, please call 773-878-6888, ext. 3.

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* 1. First name

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* 2. Last name

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* 3. Gender

Female

Male

Other (specify)

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* 4. Street Address

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* 5. City

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* 6. State

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* 7. Zip Code

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* 8. Phone number

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* 9. Email address

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* 10. Date of birth

Month/Day/Year

Date

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* 11. We want to build this program around our community’s preferences! Please indicate what health and lifestyle topics you are interested in (select all that apply):

Advanced directives

Heart health

Assistance using other technology

Tech assistance accessing NorthShoreConnect

Physical activity/exercise offerings

Skin care

Journaling

Medicare options

Stroke prevention

Tech assistance accessing Telehealth

Long-term care

Cooking demonstrations

Back pain

Mental health support

Falls prevention

Nutrition

Cancer prevention

Medication management

Other (please specify)

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* 12. What other offerings are you interested in (select all that apply):

Volunteer opportunities at the hospital

Gardening

Special themed-dinner nights

Help navigating healthcare system (billing, appointments)

Social outings

Game nights

Intergenerational activities (bringing together younger and older people)

Other (please specify)

Join the Sapphire Circle at Swedish Hospital!

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* 1. First name

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* 2. Last name

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* 3. Gender

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* 4. Street Address

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* 5. City

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* 6. State

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* 7. Zip Code

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* 8. Phone number

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* 9. Email address

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* 10. Date of birth

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* 11. We want to build this program around our community’s preferences! Please indicate what health and lifestyle topics you are interested in (select all that apply):

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* 12. What other offerings are you interested in (select all that apply):

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* 13. Please share any other suggestions or feedback you’d like to provide.