Get Exercise Prescription

Filling out the Exercise Prescription online is an important step towards managing your health and fitness effectively. This guide will provide you with clear instructions on how to complete each section of the form accurately and thoroughly.

Follow the steps to successfully complete the Exercise Prescription form.

1. Press the ‘Get Form’ button to access the Exercise Prescription form and open it in your preferred editor.
2. Fill in the 'Patient Name' field with the individual's full name. Ensure that it is spelled correctly to avoid any confusion in the future.
3. Enter the 'Today’s Date' to reflect the current date of form completion.
4. Input the 'Date of Birth' in the designated field. This information is crucial for understanding the patient's age and related health considerations.
5. Indicate the 'Next Appointment' date to help track follow-up consultations.
6. Fill in the 'Doctor' field with the name of the healthcare provider issuing the exercise prescription.
7. Provide your signature in the designated area to authorize the Exercise Prescription.
8. Select the type of aerobic activity from options such as walking, swimming, cycling, or other activities by checking the appropriate box.
9. Specify the amount of aerobic activity required by selecting from options like 10 minutes, 15-30 minutes, 30 minutes or more, or 'Other.'
10. Indicate how many times a week you will commit to this activity by selecting from options ranging from 1-2 times per week to 5 or more times per week.
11. For strength training, choose from activities such as sit ups, push ups, squats & lunges, resistance programs (e.g., weights), or 'Other.'
12. Determine the amount of strength training needed by selecting 1 set of 8-12 repetitions, 2 sets of 8-12 repetitions, or 'More.'
13. Specify how many times a week strength training will be performed from the options: once a week, twice a week, or more than 2 times per week.
14. If applicable, provide a referral to an Accredited Exercise Physiologist by filling in their name, phone number, and address.
15. Leave any additional notes in the designated section to provide further context or information as needed.
16. Lastly, review the entire form for accuracy, then save changes, download, print, or share the completed Exercise Prescription form.

Take charge of your health by completing the Exercise Prescription online today.