MEDICAL QUESTIONNAIRE If you have previously filled in this Medical Questionnaire and nothing has changed, please go to the Book An Event Registration page, otherwise please complete the form below before registering for the event. Name * First Name Last Name Email * Has your doctor ever said that you have a heart condition or have you ever felt pain in your chest when you do physical exercise? * YES NO Have you ever suffered from unusual shortness of breath at rest or with mild exertion? * YES NO Do you often feel faint, have spells of severe dizziness or have lost consciousness? * YES NO Has your doctor ever said you have either high, or low blood pressure? * YES NO Do you have any injuries or 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? (If YES - Please use the box at the bottom of the page to give details) * YES NO Is your doctor currently prescribing you drugs or medication? (If YES - Please use the box at the bottom of the page to give details) * YES NO Are you, or is there any possibility that you might be pregnant? * YES NO If you answered YES to any questions above, please use this space to give us further details Thank you for completing the medical questionnaire. You should be redirected to the Event Registration page. If not please click “Book An Event” in the main menu.
