Prenatal water fitness summer 2012 - Texas Tech University - depts ttu-2026

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2. Begin by entering the patient's name in the designated field. This is crucial for identifying the individual requiring medical clearance.
3. Next, indicate whether the patient can participate without restrictions, with restrictions, or not at all. If there are restrictions, please specify them in the provided space.
4. Fill in the physician's name clearly, ensuring it is typed or printed legibly for verification purposes.
5. The physician must sign the form to validate their approval. Ensure that this signature is included before submission.
6. Complete the physician's address and phone number fields to facilitate any necessary follow-up communication.
7. Finally, enter the date of completion and review all entries for accuracy before submitting the form via mail, fax, or delivery as instructed.

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