The following section will be completed by the trainer at the initial consultation:
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):
Rate your fitness (1-Poor, 5-Average, 10-Excellent):
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