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PHYSICAL ACTIVITY READINESS QUESTIONNAIRE

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by your doctor?
Have you ever felt pain in your chest when you perform physical activity?
Is there any history of Coronary Heart Disease in your family?
Do you frequently feel faint, or have spells of dizziness or lose consciousness?
Are you, or is there any possibility that you might be, pregnant?
Are you currently being prescribed any medication by the doctor?

Do you have any other limitations that must be addressed before partaking in any program, class or in person such as, diabetes, high blood pressure, low blood pressure, high cholesterol, arthritis, back problems or any current injuries?

IF you answered ’Yes’ to one or more questions, please consult your doctor IF you have not already done so. Ask your doctor’s advice on your suitability for physical activity.

Thank you. You can now complete your booking.

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