Physical Activity Readiness Questionnaire Please answer the following questions to determine your ability to engage in physical activity Has A Doctor Diagnosed With Heart Disease and Should Only Perform Physical Activity Recommended By A Doctor? * Yes No Do You Feel Pain In Your Chest When Performing Physical Activity? * Yes No In The Past Month, Have You Had Chest Pain While Not Performing Physical Activity? * Yes No Do You Lose Your Balance Because Of Dizziness? * Yes No Do You Ever Lose Consciousness? * Yes No Do You Have A Bone Or Joint Problem That Is Worsened By Physical Activity? * Yes No Is Your Doctor Prescribing Any Medication For Blood Pressure Or Heart Condition? * Yes No Do You Have Any Other Reason Why You Should Not Engage In Physical Activity? * Yes No Thank you! Please review and Sign Waiver