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 - London
Ontario - Woodstock
Ontario - St. Thomas
Ontario - Markham
Ontario - Stouffville
Ontario - Toronto
Ontario - Windsor/Chatham-Kent
Ontario - Bancroft/Haliburton
Ontario - Durham Region
Ontario - Kingston
Ontario - other
Ontario - Tillsonburg
Ontario - Ingersoll
Ontario - Uxbridge
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.
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
Receive a Getting Started guide plus tips and tricks about how to get active by signing up for the newsletter.
We aim to make this program the best it can be. Check this box if we can contact you for your feedback.
This iframe contains the logic required to handle Ajax powered Gravity Forms.
Tell your doctor about Prescription to Get Active
Not all doctors are aware of this program. Get the conversation started by
downloading this handout.