Physical Activity Readiness Questionnaire
Email address
Has your doctor ever said that you have a heart condition and that you should only do 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 that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Are you pregnant, breastfeeding or had a baby in the last 6 weeks?
Are you suffering from or have you ever suffered from mental health disorder i.e Depression, Anxiety, Eating Disorder
Would you like to be added to my newsletter for updates on classes, PT and any offers? If yes, What is your email address?
Your answer
A copy of your responses will be emailed to the address you provided.
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