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Terms: $17.50 / Week
 

  • Weekly – Initial Payment

    $17.50 / Week

    $17.50
Total
$17.50

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      If an ambulance is ever needed, this is the address we give them.






      Emergency contact

      Someone we can reach if there's ever an emergency during your session.



      Are you currently exercising?

      Light activity per week (easy walking, gentle yoga, gardening)

      Moderate activity per week (brisk walking, swimming, cycling)

      Vigorous activity per week (running, fitness boxing, HIIT)

      Have you done structured exercise classes before?

      Now, let's talk about your goals.

      Which of these are important to you? Tick as many as you like.





      Tough love? Gentle encouragement? A little of both? Tell us.

      Section 1 · Medical safety

      Has your medical practitioner ever told you that you have a heart condition, or have you ever suffered a stroke?

      Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?

      Do you ever feel faint, dizzy or lose balance during physical activity/exercise?

      Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?

      Are you living with type 1 or 2 diabetes?

      Section 2 · General health & family history

      Do you have a family history of heart disease (e.g. stroke or heart attack)?

      Have you ever been told that you have high blood pressure?

      Have you been told that you have high blood sugar (glucose)?

      Have you ever been told that you have high cholesterol / blood lipids?

      What is your gender?

      Section 3 · Lifestyle & injuries

      Do you smoke cigarettes on a daily or weekly basis, or have you quit smoking in the last 6 months?

      Have you spent time in hospital (including day admission) for any condition, illness or injury during the last 12 months?

      Do you have any diagnosed muscle, bone, tendon, ligament or joint problems that you have been told could be made worse by participating in exercise?

      Section 4 · Medications & other details

      Are you currently taking prescribed medication(s) for any condition(s)?

      Are you currently pregnant, or have you given birth in the last 6 months?




      Step 1 of 4


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