GP EXERCISE REFERRAL FORM - Westway Trust - sports westway 2026

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  1. Click ‘Get Form’ to open the GP EXERCISE REFERRAL FORM in the editor.
  2. Begin by filling in the PATIENT section. Enter the patient's name, address, telephone number, date of birth, NHS number, and gender. Ensure all details are accurate for effective processing.
  3. Next, complete the REFERRER section with your name, address, telephone number, and fax number. This information is crucial for communication regarding the referral.
  4. In the CLINICAL INFORMATION section, provide baseline measurements such as resting heart rate, blood pressure (BP), and BMI. List any relevant medications and contraindications for exercise to ensure patient safety.
  5. Select the REASON FOR REFERRAL by checking appropriate boxes based on the patient's condition. This helps in tailoring the exercise program effectively.
  6. Indicate the preferred EXERCISE LOCATION by choosing one of the two addresses provided. For further inquiries about the program, you can contact us directly.
  7. Finally, sign and date in the AUTHORISATION section to confirm that all information is accurate and that there are no contraindications for exercise.

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As well as delivering sessions, exercise referral practitioners also design safe and effective programmes while ensuring a safe environment. They use their knowledge and skills to review and adapt programmes depending on a patients needs.
National Exercise Referral Scheme The scheme offers an individual 16-week activity programme designed for you and during this time, You can access Leisure Facilities at a concessionary rate. Make an appointment with your GP to find out more.
Exercise referral, also known as GP exercise referral, is the process of a medical or health professional referring a patient to a fitness programme. The overall aim of the exercise referral process is to improve a patients health through exercise, and to encourage them to lead a more active lifestyle in the future.
To become an exercise referral practitioner, you need to complete a qualification such as: Level 3 Diploma in Supporting Clients with Long Term Conditions. Level 3 Diploma in Supporting Participation in Physical Activity: Long-Term Health Conditions. Level 3 Diploma in Exercise Referral.
The NHS GP Exercise Referral Scheme is designed for patients who are sedentary or have health conditions that could be improved through physical activity. To access this service, patients must meet specific criteria as determined by the GP before they can go through the structured referral process.

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People also ask

And sometimes, your GP might decide you need to see another healthcare professional for specialist tests, treatment or care. When they request specialist tests or treatment on your behalf, this is known as a referral. Examples of referrals could include: Scans or tests for a diagnosis of a condition or health issue.
A GP referral service is when a GP refers you to a leisure center for excercise when you have a qualifying condition ie; diabetes, COPD, etc. Usually the referral means free use of the councils leisure centers for a number of weeks 12 or more.
Legally, yes. Any licensed MD, DO, NP, or PA in California can write a prescription or letter of medical necessity (LMN) stating that a structured exercise programincluding access to a gymis integral to treating or managing a patients condition.

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