Shape up 4 Life Monitoring Form - Client Consent PRIVATE & CONFIDENTIAL

    • I confirm that I wish to lose weight and have enrolled as a member of the SU4L programme

    • I understand that my aim is to lose 5% of my starting body weight

    • I confirm that I will take part in any physical activity at my own risk but should my health change or I have concerns, I will consult with my GP and inform my instructor without delay

    • By accepting a place on the SU4L A course I understand that I commit to the 12-week programme and will inform my instructor of any absences.

    • I agree to be contacted again for a follow up appointment 6 and 12 months following this course.

    • Solutions4health would encourage you to provide your consent in order that we can process data and information about you. We may share this data where necessary with other health professionals such as your GP or specialist services. The information we collect and process will be used to help us meet the contractual obligations as set down by the local health service commissioners in accordance with the service we are providing. You can request to view, amend or delete your data at any time by contacting us.

    • Solutions4Health is not a medical organisation and so cannot give you medical advice or diagnosis. An assessment will be undertaken to assess your eligibility and if we find that the programme may not suit your needs we may not be able to enrol you onto the programme.

    • By registering onto the SU4L programme, you are agreeing to participation in the activities held in the sessions. We will undertake an assessment prior you joining in the physical activities however should we identify that you may not be appropriate or see any risks to injury you may not be enrolled onto the programme. We may ask you to seek medical advice or approval before taking part. For most people, physical activity should not pose any problems.