YouCan Fitness Pre-Exercise Screening
This form will take approximately 5-10 minutes to complete.

This form should be completed by all adults 18 years and over. For children under 18 years of age, a legal guardian must complete the Youth Pre-Exercise Screening Form available here -

The questions in this screening tool are taken from the Exercise & Sports Science Australia Adult Pre-Exercise Screening System (APSS) which also includes guidelines (User guide here - on how to use the information collected and to address the aims of each stage. No warranty of safety should result from its use. The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by YouCan Fitness, Exercise & Sport Science Australia, Fitness Australia, Sports Medicine Australia or Exercise is Medicine for any loss, damage, or injury that may arise from any person acting on any statement or information contained in this system.

Should you have any questions about the screening form or about the service YouCan Fitness offers, please contact me for clarification at prior to your first session.
Email address *
Your Full Name *
Your Phone Number *
Your Date of Birth *
Your Gender *
Your Address *
Due to the nature of our sessions being conducted online, this information is required so your location can be given to emergency services in the unlikely event of a major emergency occurring during your sessions. PO Boxes cannot be accepted. You may choose not to provide this information, however I am unable to provide you with my services without this information. Your safety and privacy is of utmost importance to me and this information will only be used for the purpose explained above.
Could you please tell me in a few words how you found YouCan Fitness? *
It really helps me understand how to reach more amazing people like yourself. If you found us via Google, please tell me what search term you used.
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