Referring to Heartmoves

Clients can self refer into Heartmoves exercise programs or they can be referred by their GP, nurse or allied health professional, community health team, or aged care team. The Pre-exercise Assessment and Referral form (PEAR form) is a one-page form designed for multiple purposes:

  • as a referral form for use by health professionals
  • as a screening form for use by Heartmoves leaders and centres to identify those clients who may need medical clearance prior to exercising
  • as a monitoring tool for the YMCA to collate de-identified data on program growth and characteristics


The PEAR form is available to GPs and health professionals as either:

  • a pad containing 50 carbonized forms (with copies for the GP, health professional, fitness leader and YMCA Australia). These pads are often purchased ($30.00 plus postage) by practice nurses, rehabilitation teams, allied health professionals and community health teams, who prefer a hard copy referral process. Contact (03) 9693 9777 to order Heartmoves PEAR form pads;
  • an electronic file in rich text format compatible with Medical Director software, mainly used by GPs.


Click here for the Electronic (MD Compatible) version of the PEAR form
Click here for directions on how to load the form onto Medical Director

Heartmoves leaders can be an “Other provider" in a Team Care Arrangement initiated by a GP or a Practice Nurse. This enables the Heartmoves leader to provide a supervised and safe ongoing exercise program (either group or individual) tailored to the individual goals established by the client with their GP. The Heartmoves leader is trained in professionally responding to a Care Plan and they can provide a standardised Acknowledgement of Care Plan Form (signed) as well as Feedback Forms on progress to goals for the 6 month Review process. The one page PEAR form allows GPs and Practice Nurses to communicate easily to the Heartmoves leader concerning:

  • referral to Heartmoves
  • medical clearance to exercise
  • screening of chronic conditions
  • presence of a Care Plan and the goal(s) for the Care Plan
  • request for Feedback on progress in either 3, 6, or 12 months
  • individualised contraindications
  • privacy and consent permissions


Heartmoves Fitness Professionals are not eligible for a Medicare Provider Number, however, in relation to cost, the low per session fee (most programs charge between $4.00 - $10.00 per session) for a Heartmoves group class means that the client is more able to afford the service, and many Heartmoves programs also offer discounts for seniors, as well as free introductory sessions and a “come and see" session.

Other Allied Health Professionals (especially physiotherapists, dietitians and exercise physiologists) who are involved in Medicare funded Team Care Arrangements for the 5 allowed consultations per year, are also utilising referrals to local Heartmoves exercise programs for ongoing maintenance and enhancement of exercise behaviour change.

Tips to enhance behaviour change though a referral to Heartmoves :

  • use the Locality Directory to locate the program most suitable to your client and refer to this specific location (rather than a general referral to Heartmoves);
  • place the completed PEAR form in an envelope with the name and contact number of the Heartmoves leader/centre on the front and give to the client to take to the Heartmoves program;
  • it is also possible to fax through the completed PEAR form to the Heartmoves leader/centre, who can then expect and follow up with the referred client;
  • invite local Heartmoves leaders to Cardiac and other Rehabilitation programs, and into any short term Lifestyle modification programs, to meet the clients and describe/demonstrate their programs and invite clients to their introductory Heartmoves session;
  • some Cardiac Rehabilitation Co-ordinators have found success in actually being at a Heartmoves class on a regular basis to support their referred clients for their first exercise session;
  • have the Heartmoves home based DVD available for viewing as this can overcome some of the client's barriers to beginning a Heartmoves exercise program;
  • inform client that you are requesting feedback from the Heartmoves leader in relation to progress to goals
  • have Heartmoves fliers (describing what to wear, and the benefits) available for the client to take away, and display Heartmoves posters


Click here to download a Heartmoves flier or ring 03 9693 9777 to order Heartmoves pamphlets or posters.

Tips to build local referral partnerships with local Heartmoves leaders/centres:

  • invite your local Heartmoves leader(s) to meet with your health team members. This builds local referral pathways and can help identify particular needs (eg for an after hours Heartmoves program for those with risk factors for diabetes);
  • invite local Heartmoves leaders to any appropriate in-service sessions for your team. They would be happy to deliver a short seated presentation;
  • invite local Heartmoves leader(s) to provide short seated exercise breaks during seminars and conferences your health teams may be facilitating;
  • add local Heartmoves program details into your newsletters;
  • help the YMCA to increase the number of local Heartmoves programs, by contacting your local fitness centres and asking if they have Heartmoves as you are keen to refer your patients with chronic conditions.


For further information on referral pathways or establishing or growing Heartmoves programs in your area please contact