Medical Endorsement of Exercise & Lifestyle Management Authorization Form
Sign in to Google to save your progress. Learn more
By submitting this form you consent to  have your name added to the list of signators to the Medical Endorsement of Exercise and Lifestyle. Physicians, medical professionals, and individuals with a PhD in public health or related fields are eligible to sign this letter. A copy of the document can be viewed at:
Full Name *
Organization *
State *
Credentials (e.g. MD, MPH, PhD, etc) *
Preferred email *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of IHRSA. Report Abuse