Step 1

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.”

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.

Step 2

MEMBERSHIP REGISTRATION

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Membership Level change

You have selected the Elite Upfront membership level.

This is the Elite membership that is paid upfront.

Cost is $1800.00 Upfront for 1 Year.

Bank details for electronic funds transfer:

Suncorp
Fit Stuff
BSB 484-799
Account 451 489 224
Reference: Name and package

The price for membership is $1,800.00 now.

Membership expires after 1 Year.

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