GP Movement & Activity Programme

1. Please complete this form to request a member of the High Life Highland team to get in touch to arrange for you to participate in the GP Movement and Activity Programme and to get your free 7 session pass along with an introduction to everything your local leisure facility has to offer which can benefit your health and wellbeing.

If you have any difficulties in completing this form or accessing the GP Movement and Activity Programme please email: active.health@highlifehighland.com *This question is required.

Title *This question is required.

Forename *This question is required.

Surname *This question is required.

Address Line 1 *This question is required.

Address Line 2

Address Line 3

Town/City *This question is required.

Postcode *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

2. Date of Birth *This question is required. (DD/MM/YYYY) This question requires a valid date format of DD/MM/YYYY.

calendar