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Community of healthy FIT women

Partnering for Care: A Call for Trusted Referrals

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We Welcome Referrals from Health Professionals

Bollyfit Active CIC welcomes referrals from GPs, social prescribers, health and wellbeing teams, and community partners.

Our programmes support South Asian women’s physical activity, emotional wellbeing, confidence, and social connection in culturally relevant and empowering spaces.

Please use the form below to refer participants to our sessions. Once submitted, a member of our team will contact the participant directly.

We're Excited to Accept Referrals from GPs, Social Prescribers, Health and Wellbeing Teams, And Community Partners

Referral Form for
Health Professionals

Referrer Details (required)

Participant Details

Participant Date of Birth
Day
Month
Year

Reason for Referral (tick all that apply)

Reason/s for Referral

Relevant Health Conditions or Considerations

Programme Being Referred To (tick one or more)

Programme/s Being Referred To

Consent (required)

Additional Notes (optional)

Date & Time of Form Submission
Day
Month
Year
Time
HoursMinutes
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Your Trust in Us Means a Great Deal, and Together We Can Make a Positive Difference in the Lives of Those We Support.

Privacy / GDPR Statement

Bollyfit Active CIC processes personal data for the purpose of service delivery, safeguarding, and participant support.

All information is stored securely and accessed only by authorised personnel.

Data will be retained only for as long as necessary in accordance with GDPR and our internal policies.

For any questions regarding data protection, please contact us at:

info@bollyfitactive.org

Are you a woman interested in joining our programmes through self-referral? If so, please complete the form below

Self-Referral Form

Women who would like to join Bollyfit Active programmes directly can complete the form below. Our team will get in touch to guide you to suitable sessions.

Participant Date of Birth
Day
Month
Year

What programme/s are you interested in?

Programme/s interested in

How did you hear about us?

Consent (required)

Date and Time of Form Submission
Day
Month
Year
Time
HoursMinutes
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