Medical Health Screening Questionnaire

(Please note that this information will be confidential)

Please answer these questions truthfully and completely. The purpose of this questionnaire is to ensure that you are fit and healthy enough to participate in exercise.

Persons must consult their doctor and receive clearance before exercising if they:
• have a known history of medical disorders (i.e. hypertension, heart or lung disease)
• have a fever, suffer from fainting or dizzy spells
• are currently unable to train because of a joint or muscle injury