Prescription To Get Active
Why Get Active?
Record your prescription
Did you get a prescription? Let us know.
Province/Region (please select closest match)
Alberta - Edmonton
Alberta - Calgary
Alberta - Red Deer
Alberta - Other
Ontario - Bancroft/Haliburton/Muskoka
Ontario - Durham Region
Ontario - Ingersoll
Ontario - Kingston
Ontario - London
Ontario - Markham
Ontario - St. Thomas
Ontario - Stouffville
Ontario - Thunder Bay
Ontario - Tillsonburg
Ontario - Toronto
Ontario - Uxbridge
Ontario - Windsor/Chatham-Kent
Ontario - Woodstock
Ontario - other
Did you receive a Prescription To Get Active from your doctor or other healthcare provider?
Yes, I received a prescription from my healthcare provider and wish to register.
No, I do not have a prescription but am interested in learning more about an active lifestyle.
Name of Prescriber (or Clinic)
How fit are you right now?
Poor - I'm not active now but I'm here to make an improvement.
Average - I'm active once in awhile but generally I'm "out of shape".
Good - I consider myself to be fairly fit.
Very Good - I'm meeting/ exceeding the recommended activity guidelines.
How many days per week are you currently active?
On average, how many minutes per day are you currently active?
More than 60 minutes
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Tell your doctor about Prescription to Get Active
Not all doctors are aware of this program. Get the conversation started by
downloading this handout.