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oThis document is for use at GSA training courses and update sessions.

Please complete this confidential questionnaire designed to help us, and you, identify any areas of your 
health which may influence your ability to safely take part in GSA physical intervention/restraint and 
breakaway physical skills training.

This training is designed to be accessed by people of a wide range of ages, weight, co-ordination and 
levels of physical fitness. It is designed to ensure that you will be able to carry out the day to day training 
requirements more safely.

If you are concerned about any aspect of your health in the context of physical skills training, we 
recommend that you seek advice from your GP or Occupational Health Department prior to attending 
physical skills training.

Please discuss any concerns you may have with your health on completion of this form with the course 
tutor prior to the course commencement or on the day of training prior to the course.

Failure to declare injuries or pre course medical conditions places the responsibility on the participant and 
not the training faculty.
 
All questions must be answered.