Get the free Exercise referral form - Cambridge City Council

Cambridge City Exercise Referral Scheme 12week program Initial Assessment: This involves a mini health check and assessment of your goals. You and your instructor will plan a program of exercise to

How to fill out exercise referral form

How to fill out exercise referral form

1. Start by collecting all the necessary information, such as the patient's personal details, medical history, and current fitness level.
2. Ensure that you have the correct exercise referral form. This can usually be obtained from the healthcare provider or fitness facility.
3. Begin by filling in the patient's personal information, including their full name, date of birth, address, and contact details.
4. Move on to the medical history section, where you need to record any pre-existing conditions, allergies, or medications that the patient is currently taking.
5. Provide details of the referring healthcare professional, including their name, contact information, and any specific instructions or recommendations they have given.
6. Assess the patient's current fitness level by recording their height, weight, and body measurements. This information will help determine the appropriate exercise program.
7. Specify any limitations or special requirements the patient may have, such as disabilities or injuries that need to be considered during the exercise program.
8. Finally, make sure to review the form for any errors or missing information before submitting it to the appropriate healthcare provider or fitness facility.
9. Keep a copy of the exercise referral form for your records.

Who needs exercise referral form?

1. Exercise referral forms are typically needed by individuals who are referred to exercise or fitness programs by their healthcare provider.
2. This can include patients with medical conditions that may benefit from exercise, individuals recovering from injuries or surgeries, or those looking to improve their overall health and fitness under professional guidance.
3. The form helps ensure that the exercise program is tailored to the individual's specific needs and takes into account any medical considerations or limitations.

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What is exercise referral form?

Exercise referral form is a document used by healthcare professionals to refer individuals to participate in an exercise program.

Who is required to file exercise referral form?

Healthcare professionals such as doctors, physiotherapists, or nurses are required to file the exercise referral form.

How to fill out exercise referral form?

To fill out the exercise referral form, healthcare professionals must provide their contact information, the patient's information, medical history, and exercise recommendations.

What is the purpose of exercise referral form?

The purpose of the exercise referral form is to ensure that individuals with certain medical conditions are safely and effectively referred to exercise programs.

What information must be reported on exercise referral form?

The exercise referral form must include the patient's name, contact information, medical history, current medications, and exercise limitations.