Physician’s Release

Physician,

You have received this because one of your patients would like to start a personal training/exercise coaching program with Coach Me Strong. Our intake specialists have requested a medical release for exercise prior to your patient starting the program.

The coaching program guides the patient in aerobic exercise, strength training, and specialty programs such as yoga, Pilates, etc.

To help your patient make the best choice for his/her health and fitness, please complete and submit the short form below.

If you have any questions, please contact us by clicking here.

If your internet system prohibits submission of this online form, download the PDF paper form by clicking here.

  • Date Format: MM slash DD slash YYYY