Medical certificate for admission to fitness and sport
The undersigned doctor in medicine
Name and first name:
certifies that:
Name:
First name:
Residing in:
Street nr. bus
Postal Code, town:
o is admitted to practise sports and fitness practice.
o is admitted to practise sports and fitness activities, with the exception of
.........................................................................................................................................................................................................................................................................................................................................................................................................
o is not admitted to practise sports and fitness practice.
(cross the correct answer)
Signature and date:
Stamp of the doctor:
Bring this certificate, completed, to our first appointment.
Miguel Milo
Master in physical education
www.miguelmilo.com
0485/ 84 40 83