Par Q Form | FITMOB

Have you been hospitalised in the last 12 months?

No

Yes

Are you suffering from a medical condition, illness, or injury?

No

Yes

Are you pregnant or have you given birth within the last 6 months?

No

Yes

Do you experience any chest or heart pain when exercising?

No

Yes

Do you experienced any dizziness whilst exercising?

No

Yes

Do you experience any asthma or exercised induced asthma?

No

Yes

Do you suffer with high blood pressure?

No

Yes

Do you suffer with low blood pressure?

No

Yes

Do you have any bone or joint problems?

No

Yes

Do you know of any other reasons that may effect your abilty to exercise?

No

Yes

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