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Exercise Prescription & Referral Form Patient Name: Todays Date: Date of Birth: Next Appointment: Doctor: Signature: AEROBIC STRENGTH Type of activity: Type of activity: Walking Swimming Cycling.

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Exercise prescription includes the type, intensity, duration, frequency and progression of physical activity. These five components are applicable to the development of exercise programs for persons regardless of age, functional capacity, and presence or absence of CHD [coronary heart disease] risk factors or CHD.

If you haven't exercised for a long time or are concerned about the effects of exercise on your body or health, ask your GP about exercise on prescription. Lots of GP surgeries across the country prescribe exercise as a treatment for a range of conditions, including depression.

An exercise prescription should include the following components: Frequency, Intensity, Type, Time, and Progression (FITT-PRO) of exercise. Table 313–15,18,19 provides recommendations for prescribing aerobic, resistance, and flexibility training for older adults.

Fitness (FITT Principle), when considering exercise prescription you should keep four factors (Frequency, Intensity, Time, and Type) in mind.

Exercise prescription is based on 5 principles: type, duration, frequency, intensity, and volume. Each measure has guidelines for what parameters denote vigorous, moderate, and low intensity exercise.

The total dose or amount is determined by the three components of activity: frequency, duration, and intensity. Frequency is commonly expressed in sessions, episodes, or bouts per day or per week.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232