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Junior Physical Activity Service (PARS) – Manchester

Junior Physical Activity Service

Welcome to the Junior PARS Service. This service is a 10 week social prescribing programme for 5-17 year olds who are overweight or obese (above 91st centile). The service is commissioned by Manchester City Council and works with young people to assess their current lifestyle and activity habits and connects them to the local neighbourhood offer working with key local organisations.

Junior PARS uses motivational interviewing to support behaviour change with a key focus on a "whole family" approach to reducing sedentary behaviour and improving healthy lifestyle choices.

Before referring, please check the child meets the inclusion criteria and does not meet any of the exclusion criteria for the service.

Inclusion Criteria

Aged 5-17yrs.
BMI > 91st Centile.
Resident in Manchester Postcode or registered with GP in Manchester area.

Exclusion Criteria

Must not currently be active to recommended levels.
Has chronic condition that requires rehabilitation.

Fields marked with an * are required fields.

Referrer Details

Referring organisation

First name

Surname

Phone number

Email address *

Registered GP of young person

Does the child or young person currently have a child protection plan / child in need plan? *

Yes No

Young Persons' Details

First name *

Surname *

Date of birth *

Gender *

Address *

Town *

County *

Postcode *

Height (cm) *

Weight (kg)*

BMI Centile *

If you are unsure of the child's measurement, please use this website to calculate this prior to referral: BMI healthy weight calculator
If the BMI is calculated as below the 91st Centile, the child will not be eligible for the Junior Physical Activity Service.

Parent or guardian name (emergency contact) *

Primary contact number *

Relationship to child *

Parent or guardian Email Address

Medical conditions (tick all that apply)

Allergies

Anxiety

Asperger's

Asthma

Asthma (Chronic)

Asthma (Exercise Induced)

Cystic Fibrosis

Depression & anxiety

Diabetes (Type 1)

Diabetes (Type 2)

Epilepsy, seizures or fits

Hearing Impairment

Heart valve disorder

Inactive

Learning Disabilities

Long COVID

Mental health condition

Mild Depression

Musculoskeletal (pain/injury)

Physical Disability

Stress/Anxiety

Visual Impairment

Other

Please provide any further information to the PARS service that is relevant to consider in the prescription of a physical activity programme e.g. details around medical conditions, relevant medications or accessibility requirements, safeguarding etc.

Consent

By referring this individual, I have considered the benefits versus any health risks and consider this child suitable to take part in a tailored exercise programme.

The Parent/Guardian has consented to a referral being made to the MoreLife PARS and that the named child is not already physically active. They are aware that completion of this form indicates consent to this information being passed on and recorded by MoreLife. That all details will be stored electronically in an appropriate confidential manner. They agree to be contacted by letter, email, telephone and SMS. The Parent/Guardian understand that by completing a referral does not indicate they have automatically been accepted onto the MoreLife PARS and eligibility will be assess during triage/initial assessment. This child has no known chronic disease or long-term condition which requires clinical rehabilitation.

Consent to provide feedback to referrer on progress and forward participant details to activity providers where appropriate.

Some of the form fields are required. Please check you have filled out all required fields.

Tick if you want to download a copy of the form as a PDF file.

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