Gym Induction Form
To be completed by a Representative of Chester Heart Support Group and retained in Gym Records File
Discharge forms received from Countess of Chester Hospital:
Letter from Doctor:
Programme cannot be commenced until discharge details have been received
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Missing field(s) above
Please sign below
Signature of Lache Representative
Attended Lache Code of Practice induction:
Hold/drag mouse to draw signature
Signature of participant
Attended exercise suite familiarisation induction:
I confirm that I have received a copy of the “Lache Guidance Notes for people using the Lache Community Centre Gym” and agree to comply with the rules listed and adhere to the programme guidance contained.