Have you ever been told that you have a heart condition?

Have you ever had a stroke?

Do you ever have unexplained pains in your chest at rest or during physical exercise?

Do you consistently feel faint or suffer from spells of dizziness?

Do you suffer from asthma and require medication? 

Do you suffer from type I or II diabetes?

Do you suffer from any major muscle or joint conditions that may limit you or be aggravated by physical activity? Do you suffer from any medical conditions that may be made worse by participating in physical activity? Yes No Do you suffer from high blood pressure over 140/90 or low blood pressure below 100/80?

 

Disclaimer: If you have answered no to all of the above questions and you are confident that you have no other concerns with your health then you may proceed to participate in physical activity.

 

If you have answered yes to any of the questions above or are unsure, please seek a referral from your GP or allied health professional before commencing physical activity.

 

I believe to the best of my knowledge that all of the information I have provided on this tool is accurate. In the case that my medical condition changes over the course of my training I will inform my trainer and fill out a new exercise pre-screening questionnaire.