Prostate FFIT - Sign Up

1
Choose your club* This field is required.Please select from the list below
Please Select
Kilmarnock FC - Rugby Park (starting Friday 6th February, 10.30am - 12.30pm)
Dundee FC - June (date & location TBC)
Aberdeen FC - September (date & location TBC)
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.So your local club can stay in touch
example@example.com
4
Please tell us what stage your prostate cancer is* This field is required.
Early
Advanced
5
Do you have access to a phone, tablet or laptop to view a weekly exercise video at home?* This field is required.
Yes
No
6
I confirm that I will seek agreement from my doctor or Clinical Nurse Specialist about taking part* This field is required.
Confirm
7
I confirm that I am happy for my details to be shared with my selected club* This field is required.
Confirm
8
How did you first hear about Prostate FFIT?
SPFL Trust social media
Prostate Scotland social media
Football Club social media
Medical practitioner
Maggie's centre
Word of mouth
Online news
Newspaper
Support group
Other
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