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Referral Form - Macmillan Move More

Referral Form - Macmillan Move More Highland Programme

Participants Details: Please complete all fields.
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Emergency Contact Information
Medical Details
This question requires a valid date format of MM/DD/YYYY.
17. Treatment Status
Participation Statement 
The Macmillan Move More Highland programme is a partnership between Macmillan Cancer Support and High Life Highland (HLH). The aim of the programme is to increase opportunities available for people that are affected by cancer to participate in physical activity. 
This person centred programme begins with a conversation around how you can incorporate physical activity as part of your lifestyle. We will then signpost you to activities that best meet your needs and interests.
Activities offered within the Macmillan Move More programme may be provided by HLH or a third party organisation.
The management and staff of HLH are dedicated to helping you take every opportunity to enjoy the facilities and services that we offer. With this in mind, we have carefully considered what we can reasonably expect of each other.
Our commitment to you:
We will provide you with suitably trained staff and volunteers.
We will always have an appointed person available who will be able to assist you with any first-aid needs. 
We will provide you with suitable equipment.
We will make every effort where possible to ensure our facilities are in a safe condition for the activity.
Your commitment to us:
You should exercise within your own ability.
If you feel ill you should let us know straight away and we will endeavour to provide assistance.
If you have any concerns about any medical reason that might affect your ability to exercise you should seek advice from a relevant health professional.