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Hertfordshire Exercise Referral Scheme: REFERRAL FORM Patient Details (Please Print Clearly)First Name:Surname:Gender: M / DOB:Home Tel:Mobile Tel:email:GP:GP Practice:Patient Address:Patient Postcode:Reason
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How to fill out exercise-referral-formdocx

01
Obtain a copy of the exercise-referral-formdocx
02
Read the instructions carefully
03
Fill in your personal information such as name, address, contact details, etc.
04
Provide details of your medical history and any existing conditions
05
Mention your reasons for seeking exercise referral
06
Sign and date the form

Who needs exercise-referral-formdocx?

01
Individuals who have been advised by their healthcare provider to participate in an exercise referral program
02
People with certain medical conditions or risk factors that can benefit from structured physical activity under supervision

What is Exercise-Referral-.docx Form?

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Exercise-referral-formdocx is a form used to refer individuals to exercise programs or fitness classes.
Healthcare professionals or fitness instructors are required to file exercise-referral-formdocx.
Exercise-referral-formdocx can be filled out by providing the individual's personal information, medical history, fitness goals, and exercise preferences.
The purpose of exercise-referral-formdocx is to assess the individual's fitness level, create a tailored exercise program, and monitor progress.
Information such as personal details, medical conditions, current fitness level, exercise restrictions, and emergency contacts must be reported on exercise-referral-formdocx.
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