Physical Activity Readiness Questionnaire

The purpose of this questionnaire is to determine whether you have any medical, health, or physical conditions that may limit or restrict how much or what type of exercise you do as a part of a strategically designed exercise training program catered to your unique needs and personal goals. Your safety is a high priority and it is my hope to proactively minimize any possibility of risk when exercising.

Please make sure to have the names of any prescription medications you may currently take nearby because one of the survey questions requests this information.

Completion of this survey takes approximately 10-15 minutes. I will contact you within 48-hours of survey completion to discuss our next steps.

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