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Footsteps for Life Referral Phone 9035610149Fax 9035617975 Patient Name:Date:DOB:Gender:Phone Number:Alternate Number:Address:City:State:Zip:Diagnosis: Stage:IIIIIIIVPrimary Language:EnglishSpanishOtherRestrictions:

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How to fill out fitsteps for life referral

01

Contact the Fitsteps for Life program coordinator to receive a referral form.

02

Fill out the referral form completely with accurate and up-to-date information.

03

Include any relevant details about the individual's health and fitness goals on the form.

04

Submit the completed referral form to the program coordinator for review and processing.

Who needs fitsteps for life referral?

01

Individuals who are looking to improve their physical fitness and overall health can benefit from a Fitsteps for Life referral.

02

People who may have health conditions or physical limitations that require specialized exercise programs could also benefit from this referral.

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What is fitsteps for life referral?

Fitsteps for life referral is a program designed to help individuals improve their health and fitness through exercise and lifestyle changes.

Who is required to file fitsteps for life referral?

Anyone who is looking to improve their health and fitness can file a fitsteps for life referral.

How to fill out fitsteps for life referral?

To fill out a fitsteps for life referral, individuals can contact their healthcare provider or fitness instructor for assistance.

What is the purpose of fitsteps for life referral?

The purpose of fitsteps for life referral is to encourage individuals to make positive changes to their health and fitness habits.

What information must be reported on fitsteps for life referral?

Information such as current health status, fitness goals, and medical history must be reported on a fitsteps for life referral form.

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