During the intake process at the ThinU Body Contouring Center, your patient completed a Participant Activity Readiness Questionnaire Form. Information on this form indicates your patient will require a physician’s clearance form. The patient has indicated the following health risk(s):
The patient’s VO2 Metabolic Exercise Assessment will take place at the ThinU Body Contouring Center located at 4075 Old Milton Parkway, Suite 4, Alpharetta, GA. 30005 and will be administered by personnel trained in use of Korr Medical Systems Metabolic Testing Systems. If you know of any medical, or other reasons why your patient should not undergo a VO2 exercise Metabolic Assessment at the ThinU Body Contouring Center, please indicate this on this form. By completing the form below you are not assuming any responsibility for our administration of the VO2 Exercise Metabolic Assessment.
Please return Medical Clearance Form to:
ThinU Body Contouring Center
4075 Old Milton Parkway, Suite 4, Alpharetta, GA. 30005