Online Training Health History & Waiver

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Waiver of Liability for Online Training

Email *

Do you have a history of heart trouble? *

Yes

Required

Do you frequently have chest pains? *

Yes

Do you often feel faint or have dizzy spells? *

Yes

Do you have high blood pressure? *

Yes

Do you have a joint problem that can be aggravated by exercise? *

Yes

Do you have neck or back issues? *

Yes

Is there a physical or psychological reason not mentioned here that would prohibit you from following an exercise program? *

Yes

Are you over 65 and unaccustomed to physical activity? *

Yes

Are you currently pregnant ? *

Yes

If you are pregnant or six weeks postpartum, have you received clearance from your physician for unrestricted physical activity? *

Yes

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