Health Questionnaire

Please fill in the form below or download our printable version to let us know of any injuries and conditions that you may have.

Please click here to download our printable Health Questionnaire.

Your Details:

Health Information

1. Do you suffer from any heart troubles? Yes No

2. Do you have high or low blood pressure? Yes No

3. Do you often feel faint or have spells of servere dizziness? Yes No

4. Do you suffer with any aches/pains in your bones/joints? Yes No

5. Do you suffer with from back pain? Yes No

6. Do you take any form of medication? Yes No

7. Have you had a recent injuries or operations? Yes No

8. Are you pregnant or have recently had a baby? Yes No

9. Please let us know of any conditions that you have been diagnosed with or been treated for by a physician:

By submitting this form, you willingly participate in the practical exercises at your own risk. You confirm that have no physical restrictions, disabilities or any predisposition to sickness or injury that may be aggravated or adversely affected as a result of your participation. You take full responsibility for any injury, loss or damage to your person or property that may arise directly or indirectly from your participation in the exercises. I will not seek to penalise, prosecute or claim compensation from the company for any injury, loss or damage.