Medical Clearance Form

Medical Clearance Form

To ensure the safety and well-being of all participants, Coach Flisha requires individuals to provide relevant medical information and clearance from a healthcare professional before participating in the exercise classes.

Participant's Full Name: __________________________ Date of Birth: __________________________

1. Please list any medical conditions, injuries, or health concerns that may affect your ability to participate in physical activities:

2. Are you currently taking any medications? If yes, please provide details:

3. Have you ever been advised by a healthcare professional not to engage in physical activities? If yes, please explain:

I hereby authorize my healthcare provider to release any relevant medical information to Coach Flisha for the purpose of evaluating my suitability for participation in the exercise classes.

Participant's Signature: __________________________ Date: __________________________

Fitness Coach Signature: __________________________ Date: __________________________