Get Pre-exercise Medical Clearance Form

Completing the Pre-Exercise Medical Clearance Form online is a crucial step for individuals seeking to initiate a health and fitness program. This guide is designed to help users navigate through each section of the form effortlessly, ensuring a smooth and accurate submission.

Follow the steps to complete your form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in your document editor.
2. Begin by entering the patient's name in the designated section. This is essential for identifying the individual for whom medical clearance is being sought.
3. Proceed to the Medical History section. Carefully indicate whether the patient has heart disease by marking the appropriate box. If the answer is 'YES,' provide any additional details as requested.
4. Check any history of chest pain, breathlessness during exercise, abnormal ECG results, or major cardiovascular investigations. Each condition should be responded to with 'YES' or 'NO,' and further specifics should be added if necessary.
5. Continue to assess the patient's history regarding high blood pressure, diabetes, high cholesterol, haematological or immune disorders, neurological disorders, and other major illnesses. Fill in the information accurately based on the patient's current and past conditions.
6. In the Medications section, indicate if the patient is currently or has recently been taking any medications. For each medication listed, provide the medication name, reason for use, dosage, duration, and any possible side effects.
7. Review the Medical Clearance statement. Indicate whether you believe there are any medical contra-indications for the patient participating in a graduated exercise program. Provide reasons if applicable.
8. Complete the form by signing it and entering the date, along with the medical practitioner's name, address, and telephone number. Ensure that all sections are checked for completeness before submission.
9. Finally, save any changes made to the form. You may choose to download, print, or share the form as needed for submission.

Start filling out your Pre-Exercise Medical Clearance Form online today to help ensure a safe and effective health and fitness journey.