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Booking Process

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Address

5678 Extra Rd. #123 San Francisco, CA 96120.

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Phone

(785) 116-1975

Physical Activity Readiness Questionnaire

If you are planning to take part in physical activity or an exercise class, start by answering the questions below. If you are between the ages of 15 and 69 the questionnaire will tell you if you should consult your doctor before you start. If you are 69 years of age, and you are not used to being very active, check with your doctor.

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

Have you ever had chest pain when you were not doing physical activity?

Do you ever feel faint or have spells of dizziness?

Do you have a joint problem that could be made worse by exercise?

Have you ever been told you have high blood pressure?

Are you currently taking any medications of which I should be made aware of ?

If yes, what?

Are you pregnant or have you had a baby in the last 6 months?

Is there any other reason why you should not participate in physical activity?

If yes, what?