WIN the Rockies homepage
[click here to advance directly to main content]

 

 Prescriptions for Health

These forms are to enhance patient and provider visits. They are designed to start a dialogue between patient and provider regarding improving health behaviors. The health prescription offers ideas related to physical activity, body image and food and eating. 

Food and Physical Activity for Health Tip Sheet (PDF format)

This sheet includes directions for health care providers to use the two forms. It also shares ideas for making large patients feel welcome. 

Food and Physical Activity Habit Inventory (PDF format)

This form is completed by the patient. Patients complete the form providing an overview of their physical activity and eating habits. 

Food and Physical Activity for Health (PDF format)

Using the habit inventory, this form becomes a prescription for health. The form can help patients set some health-related goals and includes ideas for meeting those goals.

To be able to view the materials, your browser must be either Netscape 7.0 or higher, or Internet Explorer 6.X or higher.
If your Internet browser does not meet either of these qualifications, you will have to upgrade your browser to view our materials.

Netscape
To access browser upgrades for Netscape, please visit the Netscape web site at http://isp.netscape.com/software/download3.jsp.

Internet Explorer
To access browser upgrades for Internet Explorer, please visit the Microsoft web site at http://www.microsoft.com/windows/downloads/ie/getitnow.mspx.

Please note these files are large and may take a few minutes to download on some computers.

PDF icon PDF documents require Adobe Acrobat Reader for viewing or printing. Acrobat is available free of charge from the Adobe Web site at http://www.adobe.com/products/acrobat/readstep.html


Top of Page

WIN the Rockies: University of Wyoming ~ Montana State University ~ University of Idaho