Par - Q

Name *

First Name

Last Name

Are you pregnant *

Yes

No

Do you have high/low blood pressure *

Yes

No

Has your doctor ever told you you’ve got a heart problem *

Yes

No

Are you currently on any medication? *

Yes

No

Have you ever felt chest pains, feel dizzy or feel faint whilst exercising? *

Yes

No

Do you have diabetes or asthma *

Yes

No

Have you been seriously ill in the last six months *

Yes

No