Regular physical activity is safe for most people. However, some individuals should consult their doctor before increasing their physical activity levels. This form is designed to identify potential risks and ensure that your participation in exercise is safe and appropriate.
Please read each question carefully and answer honestly by ticking "Yes" or "No."
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Has your doctor ever said that you have a heart condition or recommended only medically supervised exercise?
Do you feel pain in your chest when you perform physical activity?
In the past month, have you had chest pain when not doing physical activity?
Do you lose balance because of dizziness, or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by physical activity (e.g., arthritis, back issues)?
Are you currently taking any prescribed medications for blood pressure, a heart condition, or any other chronic illness?
Are you pregnant or have you given birth in the last 6 months?
Do you have any known medical condition or physical limitation that may require special attention or modification of your exercise programme?