Please complete the form below.

Hit Submit at the end.

Enter your first name.
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Enter your last name.
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Enter your phone number.
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Has your doctor ever said that you have a bone or joint problem, such as arthritis, that has been aggravated by exercise or might be made worse with exercise?
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Do you have high blood pressure?
Do you have low blood pressure?
Do you have diabetes mellitus or any other metabolic disease?
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Has your doctor ever said you have raised cholesterol (serum level above 6.2mmol/L)?
Have you ever felt pain in your chest when you do physical activity?
Is your doctor currently prescribing you drugs or medication?
Have you ever suffered from unusual shortness of breath at rest or with mild exertion?
Is there any history of coronary heart disease in your family?
Do you often feel faint, have spells of sever dizziness or have lost consciousness?
Do you currently drink more than the average amount of alcohol per week (21 units for men and 14 units for women?
Do you currently smoke?
Are you, or is there any possibility that you might be pregnant?
Do you know of any reason why you should not participate in a program of physical activity?
If you answered 'yes' to one or more questions:

If you have not recently done so, consult with your doctor by telephone or in person before increasing your physical activity and/or taking a fitness appraisal. Tell your doctor which questions you answered "yes'' to on the PAR-Q or present your PAR-Q copy. After medical evaluation, seek advice from your doctor as to your suitability for:
- Unrestricted physical activity starting off easily and progressing gradually and,
- Restricted or supervised activity to meet your specific needs, at least on an initial basis

No to all questions:

If you answered your PAR-Q accurately, you have reasonable assurance of your present suitability to take part in physical gym activity.

Assumption of risk:

I hereby state that I have read, understood and answered honestly the questions of the PAR-Q. I also state I wish to participate in activites that may include aerobic exercise, resistance training and stretching. I realise that my participation in these activites involves the risk of injury and even the possibility of death. Furthermore, I hereby confirm that I am voluntarily engaging in an acceptable level of exercise.

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Lifestyle Questions

The next set of questions will help me build a basic idea of your current training and eating habits, please be honest when answering, there are no wrong answers.

Describe your fitness goals.
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Describe your non fitness related goals, this could be to develop a better understanding of how to fuel your body, build a better relationship with food, feel confident in photos, change your mental perception of yourself etc.
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Gender
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If so, please add details
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If so, please list them
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Home, gym, outdoors etc
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Type your full name
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