Check any symptoms of possible coronary or metabolic disease you have recently experienced:
Chest painshortness of breathdizzy/faintingankle swellingheart palpitationsleg/feet crampingheart murmur
Risk factors for CHD (Coronary Heart Disease), MI (heart attack), Stroke or hypertension (usually caused by atherosclerosis):
Do you smoke?
How much? perDayWeekMonth
Did you quit smoking less than 6 months ago?
Do you take antihypertensive medications?
Are you currently taking Beta-blockers?
Do you get at least 30 minutes of moderate physical activity everyday?
Do you have osteoporosis?
Do you have osteoarthritis?
Do you suffer from back pain?
If yes, how often?
Are you often stressed?
If yes, how does it physically manifest?
How many times do you get sick (common cold) per year?
Do you have diabetes?
NoYes(type I)Yes(type II)
Do you eat low, moderate or high carbs?
Do you eat low, moderate or high protein?
Do you eat low, moderate or high fat?
Do you eat a variety of foods (whole grains, dairy, lean meats, fruit & vegetables with limited fat/oils)?
What level of importance do you place on exercise?
How many days per week do you want to commit to exercise?
How many minutes per day?
20 or lessabout 304560an hour (+)
Rate your fitness (1-Poor, 5-Average, 10-Excellent):
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