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Actividad física y NCDs
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EIM
Support for the Exercise is Medicine© Initiative is provided by:
Support for the Exercise is Medicine© Initiative is provided by:
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EIM Pledge
* First Name:
* Last Name:
Age:
* City:
* State:
* Email Address:
Race/Ethnicity:
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
* Type of Healthcare Provider:
Nurse
Physician
Physician Assistant
Other
* Number of Years in Healthcare:
0-5
6-10
11-15
16-20
20+
* Type of Healthcare Practice:
Academic Medical Center
Community Health Center/Clinic
Private Hospital
Public Hospital
Small Clinic Setting
* Choose how you would like to be involved:
Level 1 - Promoting physical activity in your healthcare setting
Level 2 - Assessing the physical activity levels of your patients
Level 3 - Prescribing physical activity and referring your patients to exercise professionals
Level 4 - Being an EIM Champion and catalyzing change in your local community and healthcare system
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Campus Recognition Application
* University/School Name:
* Supervisor/Advisor of Campus Leadership Team:
* Campus Level:
Gold
Silver
Bronze
* How does your campus meet the level requirements:
Gold level recognition is the highest level of recognition and signifies the implementation of one or several components of the EIM Solution on the University campus, with the potential of extending into the local community. Community partnerships provide real world experience for students, while providing service to the local community.
Gold level campuses must assess physical activity as a vital sign.
A Gold level campus must also be engaged in at least (1) of the following:
* My campus assesses their patients' physical activity as a vital sign?
Yes
No
* My campus is creating collaborations between university health care professionals and exercise professionals to provide physical activity prescriptions?
Yes
No
* My campus has non-clinical professionals/departments directing students, faculty, and/or staff to the recreation center for health and fitness counseling?
Yes
No
* My campus has a computer-based system to track patient participation in physical activity interventions?
Yes
No
Other:
Silver level recognition includes activities related to awareness and promotion, and incorporates education for the university’s students, faculty, staff, and health care professionals, as well as those in the surrounding community, on EIM and its mission on campus. Silver campuses are actively engaged in educating others on the EIM solution for both the treatment and prevention of long-term illness and disease. University students are educated on the aims of EIM in health care, potentially certified as EIM health fitness professionals, and guided on how they can play a role in making physical activity an integral part of health care.
Silver level campuses must be engaged in at least (3) of the following:
* My campus hosts classes that teach students the fundamentals of EIM on Campus and their potential role in fulfilling the mission of EIM?
Yes
No
* My campus trains students to educate campus community members on EIM and the importance of physical activity as medicine?
Yes
No
* My campus works with campus health services so that every health care provider discusses physical activity with every patient or client?
Yes
No
Other:
Bronze level recognition is the first step in creating the EIM initiative on Campus. These campuses bring attention to the growing need for physical activity and take action in helping to create a healthier, more active campus environment.
Bronze level campuses create awareness of the importance of exercise and regular physical activity for health and promote exercise to students, faculty, staff and the community through engagement in any of the following activities. Bronze level campuses must engage in at least (3) of the following:
* My campus hosts events that promote physical activity?
Yes
No
* My campus markets events that encourage all campus members to discuss physical activity with their health care professional?
Yes
No
* My campus has created options for exercise that are easily accessible to the campus community?
Yes
No
* My campus has completed a Mayoral, Governor, or University President EIM on Campus Month Proclamation?
Yes
No
Other:
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EIM Solution
Your First Name
Your Last Name
Your Email Address
Your Phone Number
Your Organization Name
Your Comments
What best describes you?
Healthcare System
Physician/Healthcare Practitioner
Employer/Insurer
Exercise Professional
Community Organization
Campus/University
Student
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Yes! Please send me the EIM monthly e-newsletter and e-mail updates about the EIM Global Healthcare Initiative.
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Contact Area Representative
If you would like to contact the EIM Representative from this location, please fill out the form below.
* Required
* Your Name
Your Organization
* Your Email Address
Your Phone
* Your Message
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