Gym Pass Health Form

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CODE FITNESS PHYSICAL ACTIVITY QUESTIONNAIRE

Has a medical professional ever advised that you have heart problems or that you are at risk of having them? *
Do you frequently have pains in your heart or chest?
Do you tend to lose conciousness or fall over as a result of dizziness?
Do you have a bone or joint problem that could be or has been aggravated by exercise?
Has your doctor ever recommended medication for your blood pressure, cholesterol or a heart condition?
Have you been diagnosed with diabetes?
Are you aware, through your own experience or a doctor’s advice, of any other physical reason against your exercising without medical supervision?
Are you over the age of 65 and not accustomed to vigorous exercise?
Have you had any serious injuries or operations including breaks and sprains throughout your life? If YES please give brief details below

If you answered YES to one or more of the above questions, please answer the following questions:

Have you consulted with your physician regarding increasing your physical activity and/or performing a fitness assessment? *
If you answered no to the question above, will you consult your physician prior to increasing your physical activity and/or performing a fitness assessment? We at Code Fitness recommend that you do seek the advice of a medical professional.

If you answered no, in doing so you accept that you are training at your own risk and we at code fitness are not liable. We at code fitness recommend that you seek the advice of a medical professional.


CODE FITNESS TERMS & CONDITIONS

T&Cs

Read our terms and conditions and health and saftey policy

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