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Health, Diet & Lifestyle Questionnaire

DOB
Day
Month
Year
Have You Used A Gym Before?
What Are Your Goals?

Health

Has The Doctor Ever Said You Have A Medical Condition And You Shouldn't Do Any Physical Activity?
Do You Ever Feel Pain In The Chest When You Do Physical Activity?
Do You Ever Experience Loss Of Balance Due to Dizziness Or Lose Consciousness?
Do You Suffer From High Blood Pressure?
Do You Have A History Of Heart Disease or Stroke?
Do You Suffer From Any Of The Following?
Have You Had Any Operation To Your Spines, Bones, Muscles, Tendons Or Ligaments?
Have You Broken Or Fractured Any Bones Before?
Do You Experience Shortness of Breath With Mild Exertion?
Are You Currently On Any Medication?
Do You Smoke?
Do You Suffer From Asthma
Are You Or Any Of Your Family Epileptic?
Are You Pregnant Or Given Birth In The Last 6 Weeks?

Lifestyle

Do you consent to photos being taken during gym sessions for promotional and social media purposes
Yes
No
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