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Thrive in Six
SC-FITNESS
PERSONAL TRAINER CARDIFF
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SC-FITNESS ONLINE CLIENT PAR-Q
Name
*
First Name
Last Name
Date of Birth
*
Address
*
Email
*
Emergency Contact Details
*
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
*
Yes
No
Do you feel pain in your chest when you do physical activity?
*
Yes
No
In the past month, have you had chest pain when you were not doing physical activity?
*
Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
*
Yes
No
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
*
Yes
No
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
*
Yes
No
Do you know of any other reason why you should not do physical activity?
*
Yes
No
If you answered YES to one or more questions, please write more details here. You may also need to talk with your doctor by phone or in person BEFORE you start your exercise programme.
*
*
I understand that once I am set up as an online client of SC-Fitness Personal Training, and have received my training program that payment cannot be refunded or deferred.
*
I take responsibility for my own safety and wellbeing whilst taking part in online coaching with SC-Fitness Personal Training.
*
I confirm that I am happy for SC-Fitness Personal Training to store my personal information and data as long as it is necessary to the service I will receive in line with the GDPR act 2018.
Signature - to confirm you are happy and ready to train with SC-Fitness
*
Thank you!