• Adult Pre-Exercise Screening System (APSS)

    This screening tool must be completed prior to undertaking the Arduous Pack Test by all participants whose medical clearance is more than 3 months old. This tool does not need to be completed if a candidate has successfully completed a medical within 3 months of the Arduous Pack Test. Personal information is kept confidential and is not shared with any staff or volunteers other than limited, internal health professionals This form is a self-declaration and is to be completed with a focus on your health since your last successful medical.

  • Personal Information

  • Gender*
  • Format: 0000 000 000.
  • Date of last cleared Arduous Medical*
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  • Today's Date
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  • Stage 1

    Aim: To identify individuals with known disease, and/or signs or symptoms of disease, who may be at a higher risk of an adverse event due to exercise. An adverse event refers to an unexpected event that occurs as a consequence of an exercise session, resulting in ill health, physical harm or death to an individual. Please complete the questions below.
  • Q1. Since your last medical clearance, has your medical practitioner told you that you have a heart condition or have you suffered a stroke?*
  • Q2. Since your last medical clearance, have you experienced unexplained pains or discomfort in your chest at rest or during physical activity/exercise?*
  • Q3. Since your last medical clearance, have you felt faint, dizzy or lost balance during physical activity/exercise?*
  • Q4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?*
  • Q5. Do you have either Type 1 or Type 2 Diabetes?*
  • Have you had trouble controlling your blood sugar (glucose)in the last 3 months?*
  • Q6. Do you have any other conditions that may require special consideration for you to exercise?*

  •  !

    Hi, We've noticed you answered yes to at least one of the first 6 questions.

    Answering yes to one of these means you will usually need to see a doctor and re-complete the Arduous Medical prior to undertaking a Arduous Pack Test. 

    Continue filling in the form if you wish but it is likely you will be referred directly for a new medical.

    Please also make sure you've read the question properly - we're asking about new conditions experienced SINCE your last medical only. 

  • Rows

  • Stage 2

    This stage is to be completed to the best knowledge of the candidate.

  • Q8. Demographic

  • Gender*

  • Q9. Family History

  • Do you have a Family History of Heart Disease (e.g. Stroke, heart attack)? A family history of heart disease refers to an event that occurs in relatives including parents, grandparents, uncles and/or aunts before the age of 55 years.
  • Rows

  • Q10. Smoking

  • Do you smoke cigarettes on a daily or weekly basis or have you quit smoking in the last 6 months?*

  • Q11. Body Composition

  • Rows

  • Q12. Blood Pressure

  • Have you been told that you have high blood pressure?*
  • Are you taking any medication for high blood pressure?*

  • Q13. Cholesterol/Blood Lipids

  • Have you been told that you have high cholesterol/blood lipids?*
  • Rows
  • Are you taking any medication for high Cholesterol/Blood Lipids?*

  • Q14. Blood Sugar

  • Have you been told that you have high blood sugar (glucose)?*
  • Are you taking any medication for this condition?*

  • Q15. Prescribed Medications

  • Are you currently taking prescribed medication(s) for any condition(s)? These are additional to those already provided.*

  • Q16. Hospitalisation

  • Have you spent time in hospital (including day admission) for any condition/illness/injury during the last 12 months?*

  • Q17. Pregnancy

  • Are you pregnant or have you given birth within the last 12 months?*

  • Q18. Joints, Muscles or Bones

  • Do you have any diagnosed muscle, bone, tendon, ligament or joint problems that you have been told could be made worse by participating in exercise?*

  • Q19. Worker's Compensation & Health Management

  • Do you currently have a workers compensation claim with the RFS or another organisation that may affect your ability to exercise?*
  • Do you currently have a Health Management Plan with the RFS or another organisation that may affect your ability to exercise?

  • I believe that to the best of my knowledge, all of the information I have supplied within this screening tool is correct.

  • Important information about this screening tool: This screening tool does not constitute medical advice. It is not intended for use to diagnose, treat, cure or prevent any medical conditions. It is not intended to be professional advice and is not a substitute for independent health professional advice. The NSW RFS does not accept liability for any claims, howsoever described, for loss, damage and/or injury in connection with the use of the screening tool, or any reliance on the information therein. While care has been taken to ensure the information contained in the screening tool is accurate at the date of publication, NSW RFS does not warrant its accuracy. No warranties (including but not limited to warranties as to safety) and no guarantees against injury or death are given by the NSW RFS in connection with the use or reliance on the screening tool. If you intend to take any action or inaction based on this form, it is recommended that you seek further information from the NSW RFS about the activities required as part of participation in the Arduous Pack Test and obtain your own professional advice based on your specific circumstances.

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