ProActive Physical Activity Referral Form and Guidance Notes

If an individual is eligible to attend ProActive, a Physical Activity on Referral Form is then completed by the referring professional.

The Referral Form can be accessed in two different ways:

Primary Care:

For professionals working in Primary Care, the ProActive Physical Activity on Referral Form can be accessed and completed electronically on EMIS. The referral criteria and leisure provider directory can also be accessed here. 

Please read the guidance notes below before completing the referral form.

Other:

Other referring health and fitness professionals outside of primary care are able to refer using the online form available below.

Please see the guidance notes below and the referral pathway to assist with completion of the referral form.

How do I refer?

Referral criteria

Referral Pathway

ProActiveSomerset
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.