Thame Fitness Class Consultation Form
Email address *
Full name *
Date of birth *
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How did you hear about Thame Fitness? *
PAR Q - Medical Questionnaire
Your safety is our highest priority. Please complete the following medical questionnaire.
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor? *
Do you feel pain in your chest when you do physical activity? *
In the past month have you had chest pain when you were not doing physical activity? *
Do you lose your balance because of dizziness, or do you ever lose consciousness? *
Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? *
Is your doctor currently prescribing medication (for example, water pills) for your blood pressure or heart condition? *
Do you know any other reason why you should not do physical activity? *
General Questionnaire
Tell us more about your fitness goals to enable us to personalise your Thame Fitness experience.
Do you partake in any recreational activities (golf, tennis, skiing, etc)? If yes please explain. *
Please give a brief explanation of your exercise history. *
What would you like to achieve from your fitness class? *
Are there any physical challenges you would like to achieve, for example being able to perform a press-up or specific movement? *
Do you currently have any injuries or are you experiencing pain in any areas of your body? If yes, please describe the injury and or location of the pain. *
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