Medical History Questionnaire

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    Have you had chest pain in the last month or do you have chest pain brought on by physical activity?
    Are you aware, through your own experience or a doctor's advice, of any other physical reasons against your exercising without medical supervision?
    Have you lost consciousness or fallen over due to dizziness?
    Do you have a bone or joint problem that could be aggravated by the proposed physical activity?
    Has a doctor ever recommended medication for high blood pressure or a heart condition?
    Do you have any metabolic diseases, controlled or uncontrolled, such as diabetes, hyperthyroidism, hypothyroidism, etc.?
    Do you take any drug or medications?
    Are there any other physical or emotional problems that may affect your training?
    Please enter one response per row
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