Get Wa Valley Lifestyle Medicine & Fitness Center Physicians Statement & Medical Clearance Form 2016-2025

This guide provides clear, step-by-step instructions for completing the WA Valley Lifestyle Medicine & Fitness Center Physicians Statement & Medical Clearance Form online. Ensuring your health and safety is our priority, and this form is essential for your fitness participation.

Follow the steps to complete the form accurately and efficiently.

1. Press the ‘Get Form’ button to access the document and open it in your preferred online text editor.
2. Fill in the 'Name' field with the participant's full name as it appears on identification.
3. Enter the 'Date of Birth' using the format MM/DD/YYYY.
4. Document today’s date in the designated field; this helps keep a record of when the form was completed.
5. Provide the 'Physician’s Name' of the healthcare provider who will review and sign the form.
6. Input the 'Phone Number' for the physician, ensuring it is direct and accurate for follow-up.
7. Fill in the 'Fax Number' to which the form will be sent; this should match the physician's fax.
8. Check the box to grant permission for your physician to release medical information necessary for the staff at Valley Lifestyle Medicine & Fitness Center.
9. Sign and date the form to acknowledge understanding and consent.
10. Leave the section labeled 'For Medical Staff Use Only' blank; this will be completed by the physician.
11. After the physician completes and signs their section, ensure the form is faxed to Valley Lifestyle Medicine & Fitness Center, using the fax number provided.

Complete your forms online today to ensure a smooth start to your fitness journey.