Use this page to request medical clearance forms to give to your cancer patients
who need a referral for exercise. The duplicate forms allow you to tear off a copy to include
in your onsite patient files. (Please note that you can
refer patients with an electronic form, and print a copy of the referral form for your files instead.)
If you have not already done so, please register with us before
you referring patients for exercise.
To receive paper forms, please fill in all fields in the form below and press
the "Send" button at the end.