MEMBERSHIP REGISTRATION

 

PRE-EXERCISE SCREENING QUESTIONNAIRE

This screening tool does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No warranty of safety should result from its use. The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by Exercise and Sports Science Australia, Fitness Australia or Sports Medicine Australia for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool. The purpose of this questionnaire is to identify those individuals with a known disease, or signs or symptoms of disease, who may be at a higher risk of an adverse event during physical activity/exercise. This stage is self administered and self evaluated.

 

All fields below are required

Your Name

Your Email

Date of Birth

Gender
MaleFemale

1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?
YesNo

2. Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise?
YesNo

3. Do you ever feel faint or have spells of dizziness during physical activity/exercise that causes you to lose balance?
YesNo

4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
YesNo

5. If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months?
YesNo

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?
YesNo

7. Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity/exercise?
YesNo

By submitting you confirm to the following: “I believe that to the best of my knowledge, all of the information I have supplied within this tool is correct.”

Once sent, scroll DOWN to continue registration below.

 

IF YOU ANSWERED ‘YES’ to any of the 7 questions, please seek guidance from your GP or appropriate allied health professional prior to undertaking physical activity/exercise.

IF YOU ANSWERED ‘NO’ to all of the 7 questions, and you have no other concerns about your health, you may proceed to undertake light-moderate intensity physical activity/exercise.

 


 

 

MEMBERSHIP INFORMATION

 

DOWNLOAD FORM

NOTE: Please download this Direct Debit Form and email it back to [email protected] to complete your Membership Purchase.

 

WEBSITE MEMBERSHIP ACCESS

Please ignore the $0 amount below and on your downloaded Direct Debit Form, please enter the full purchase amount and membership level you are signing up for.

Don’t forget to sign up to our Fit Stuff Newsletter to keep up to date on your membership.

Membership Level change

You have selected the Annual Weekly membership level.

This is the Annual level membership that is paid weekly. Please ignore the $0 amount below.

The weekly payment amount for this membership is $45.00 which is to be written on your Direct Debit Form.

The price for membership is $45.00 now.

Membership expires after 40 Weeks.

Do you have a discount code? Click here to enter your discount code.


Account Information Already have an account? Log in here

LEAVE THIS BLANK

Terms of Service

To finalise your membership please print, sign and return our Terms Of Service Form

DOWNLOAD FORM

Join our mailing list.