TIDEFITNESS Coaching enquiry

1

What's your name? :)

First Name

Last Name

2

What's your email address?

example@example.com

3

What's your phone number?

Please enter a valid phone number.

4

Do you have any current or previous injuries/conditions?* This field is required.

5

Do you want 3 days a week or 5 days a week workout plan?

3 Days a week (3 Full body workouts)

5 Days a week (3 Lowers and 2 Uppers)

6

PAR-Q (Physical Activity Readiness- Questionnaire)* This field is required.Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?

YESNO

7

2/7* This field is required.Do you feel pain in your chest when you do physical activity?

YESNO

8

3/7* This field is required.In the past month, have you had a chest pain when you were not doing physical activity?

YESNO

9

4/7* This field is required.Do you lose balance because of dizziness or do you ever lose consciousness?

YESNO

10

5/7* This field is required.Do you have a bone or joint problem ( for example back, knee or hip) that could be made worse by a change in your physical activity?

YESNO

11

6/7* This field is required.Is your doctor currently prescribing medication for your blood pressure or heart condition?

YESNO

12

7/7* This field is required.Do you know of any other reason why you should not take part in physical activity?

YESNO

13

If yes to any of the above please add your comments here:

14

I have read, understood and accurately completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable levelof exercise, and my participation involves a risk of injury.* This field is required.

Clear

15

Having answered YES to one of the questions above, I have sought medical advice and my GP has agreed that I may exercisePLEASE SKIP IF YOU DID NOT TICK YES

Clear