California Physicians
Sign-up Here to Pledge Your Support for
Exercise is Medicine
And Download Your Free Prescription Forms

I am a California Physician and I pledge to support the Exercise is Medicine initiative by encouraging my patients to be physically active at least 30-60 minutes a day at least 3 days a week. I understand that by filling out the form below I am joining a group of committed physicians who are taking action to help Californians develop positive health habits that will last a lifetime.

First Name:
Last Name:
Specialty:
License #:
Medical Group:	[Click here to select]
Street Address:
City, Zip Code:
Office Number:	--
E-mail:
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List of California Physician Supporters

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