1) Move Ahead Physiology Programs Screening

Move Ahead Physiology Programs

Welcome to Move Ahead Physiology. To ensure your safety, please complete this quick pre-exercise health clearance. Once cleared, you will be redirected to complete your purchase and download your program.
Please provide your details below and complete the mandatory Exercise & Sports Science Australia (ESSA) Stage 1 APSS questions.
Client Details
Name

First NameLast Name
Email Address
example@example.com
Sex
Phone Number
Please enter a valid phone number.Format: 0000-000-000.
Pre-Exercise Health Screening (APSS Stage 1)
1. Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?
2. Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?
3. Do you ever feel faint, dizzy or lose balance during physical activity/exercise?
4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
5. If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months?
6. Do you have any other conditions that may require special consideration for you to exercise?
Describe your current physical activity/exercise levels in a typical week
by stating the frequency and duration at the different intensities.

Current Exercise Intensity, Frequency and Duration.

Rows	Light Intensity Exercise	Moderate Intensity Exercise	Vigorous / High Intensity Exercise
Frequency (number of sessions per week)
Duration (total minutes per week)

Total Minutes per week = (light + moderate)+(2x minutes of vigorous / high)
If your total is less than 150 minutes per week then light to moderate intensity exercise is recommended. Increase your volume and intensity slowly.
If your total is more than or equal to 150 minutes per week then continue with your current physical activity/exercise intensity levels.
Product Agreement
I confirm all information provided above is true and correct.
I agree that if my health status changes, or if I am uncertain about proper exercise technique, I will seek professional guidance from a qualified medical or exercise professional before continuing. I assume full responsibility for my participation and agree to cease exercising immediately if I experience pain, dizziness, chest discomfort, or abnormal shortness of breath.
I understand that I am purchasing an off-the-shelf digital product, not an individualised clinical service. This product includes no ongoing coaching, personal modifications, or clinical monitoring.
I agree that all program materials, PDFs, and workout trackers are for my personal use only. Sharing, copying, or secondary distribution / sale is strictly prohibited.
I understand that due to the instant digital nature of these downloadable materials, all sales are final once access links are delivered.
Please provide your e-signature to confirm your responses and agreement.
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Move Ahead Physiology Programs