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Mt Lawley Highgate
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New Client Pre-Screening Check
LA Fit Studio New Client Pre-Screening Check
Hi, welcome to LA Fit Studio! For your health and safety, please complete this brief questionnaire prior to your first class.
1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?
2. Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise?
3. Do you ever feel faint or have spells of dizziness during physical activity/exercise that causes you to lose balance?
4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
5. If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months?
6. 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?
7. Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity/exercise?
8. Is there anything else we should know about your health that may affect your work out?
9. What is your main reason for visiting us today?
Improve cardio fitness
Improve overall health
Stress relief / mental wellbeing
IF YOU ANSWERED
to any of the 7 questions, please seek guidance from your GP or appropriate allied health professional prior to undertaking your first class at LaFit Studio.
IF YOU ANSWERED
to all of the 7 questions, and you have no other concerns about your health, please complete the form below. We look forward to seeing you at your first class!
Date of Birth
Stay In the Loop
Receive class booking notifications and reminders
Receive special offers and news
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Relationship to You
If you were referred by another client please let us know who to thank!
I believe that to the best of my knowledge, all of the information I have supplied within this form is correct.
Please allow a few seconds for your form to be submitted.