health screening

Name *

First Name

Last Name

By ticking below you can sign up to our awesome community mailing list here, with loads of FREE cool stuff like workouts and recipes what more could you ask for.

DOB

MM

DD

YYYY

Date *

MM

DD

YYYY

Health screening questions

If you have answered “Yes” to one or more of the above questions, consult your doctor before engaging in physical activity. Tell your doctor which questions you answered “Yes” to. After a medical evaluation, seek advice from your doctor on what type of activity is suitable for your current condition.

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by doctor?

Do you feel pain in your chest when you perform physical activity?

In the past month, have you had chest pain when you were not performing any physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?

Do you know of any other reason why you should not engage in physical activity?