Pre-Exercise Screening Tool

STAGE 1 (COMPULSORY)

AIM: to identify those individuals with a known disease, or signs or symptoms of disease, who may be at a higher risk of an adverse event during physical activity/exercise. This stage is self administered and self evaluated

Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?*

Yes
No

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

Yes
No

Do you ever feel faint or have spells of dizziness during physical activity/exercise that causes you to lose balance?*

Yes
No

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

Yes
No

If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months?*

Yes
No

Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise?*

Yes
No

Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity/exercise?*

Yes
No

please seek guidance from your GP or appropriate allied health professional prior to undertaking physical activity/exercise

and you have no other concerns about your health, you may proceed to undertake light-moderate intensity physical activity/exercise

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Pre-Exercise Screening Tool

Step 1 of 2

STAGE 1 (COMPULSORY)

FUTURE HEALTH FITNESS

QUICKLINKS

ADDRESS

Instagram

NEWSLETTER