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Health Questionnaire
Medical Conditions. Please tick if you have or ever had:
Heart Trouble
Pain in your heart or chest when exercising
Feel faint or have spells of severe dizziness or have lost consciousness
Ever suffered from unusual shortness of breath whilst resting or with mild exertion
Has your doctor ever suggested that you have a bone or joint problem, such as arthritis that has ever been aggravated by exercise or may be made worse by physical activity
High or low blood pressure
Taking any medication that may affect your ability to exercise
Are pregnant or have had a baby in the last 6 months
Aware of any medical reasons why you should not be participating in physical exercise
Do you currently have a fever?
Do you have a persistent cough lasting more than an hour?
Does anyone in your household have symptoms of the corona virus?
Submit
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