HEALTH QUESTIONNAIRE

Please read the below following information. Common sense is your best guide when you answer these questions.

If you answer 'YES' to one or more of the following questions you must consult your doctor before commencing an exercise programme.

1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

2. Do you feel pain in your chest when you do physical activity?

3. In the past month, have you had chest pain when you were not doing physical activity?

4. Do you lose your balance because of dizziness or do you ever lose consciousness?

5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?

6. Is your doctor currently prescribing drugs for our blood pressure of heart condition?

7. Do you know of any other reason why you should not do physical activity?

8. Are you pregnant or have you given birth in the last three months?