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1. Do you have a bone or joint or recent injury that could have be made worse by a change in your physical activity?
2. Have you had any form of operation in the past 6-12 month, or are due to have any surgeries?
3. Have you recently had any chest pains when not undertaking physical activity?
4. Do you feel pain in your chest not undertaking physical activity?
5. Has your doctor ever said you should only carry out physical activity under medical supervision?
6. Do you ever lose you balance because of dizziness or do you ever lose consciousness?
7. Are you currently pregnant or have been pregnant within the past 6 months?
8. Do you smoke?
9. Do you suffer from Asthma?
10. Are you diabetic?
11. Are you currently taking any medication that you have not mentioned?
12. Are you epileptic?
13. Are you under any form of medical supervision or undergoing any treatment that you have not mentioned? If answer is Yes, please give details.
14. Do you know of any reason not mentioned why you should not carry out physical activity? If answer is yes, please give details.