Forms for download

Guidance for Medical Professionals
Please refer to this form if you are a medical professional looking to refer a patient to the Heartworks exercise referral/phase 4 cardiac rehabilitation scheme. Please contact suebennett21@btinternet.com or 07786974907 for more information
Guidance for Med professionals.pdf
Adobe Acrobat document [145.4 KB]
BACPR Transfer Form
Please download this form if you have a medical condition related to your heart or circulation, and would like to attend cardiac rehab exercise classes. This form needs to be completed by a medical professional (e.g. GP) and taken to an exercise class, after contacting suebennett21@btinternet.com or 07786974907
BACPR Transfer Form April 2014.pdf
Adobe Acrobat document [306.1 KB]
Exercise Referral Form
Please download if you have a medical condition (which is not related to your heart or circulation) and would like to attend Heartworks cardiac rehab exercise classes. This form needs to be completed by a medical professional (e.g GP) and taken to a class, after contacting suebennett21@btinternet.com or 07786974907
Exercise Referral Form1.pdf
Adobe Acrobat document [114.1 KB]
Health Questionnaire PAR-Q
Download and complete if you are a healthy adult wishing to attend exercise classes for general health and fitness.
Health Questionnaire PAR-Q.pdf
Adobe Acrobat document [86.8 KB]
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© Copyright Claire Gurney 2015

Telephone

07776 044304

 

Email

info@clairegurneypilates.com

 

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What my clients say

"Good service and great advice"

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