* Please truthfully answer the following six questions 

                                 

 

Adult Pre-Exercise Screening System – Stage 1 

 1- Has your medical practitioner ever told you that you have a heart condition, or have you ever suffered a stroke?
            YES        NO

 2 - Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?
            YES        NO

 3 - Do you ever feel faint, dizzy or lose balance during physical activity/exercise?
            YES        NO

 4 - Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
            YES        NO

 5 - If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months?
            YES        NO

 6 - Do you have any other medical conditions that may require special consideration for you to exercise?
            YES        NO

 

If you have answered YES to any of the above 6 questions, you are advised to seek guidance from an appropriate allied health professional or your medical practitioner prior to undertaking physical activity/exercise. 

 

                                 

 No warranty of safety should result from the use of the Adult Pre-Exercise Screening System (APSS). .The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by Exercise & Sports Science Australia, Fitness Australia, Sports Medicine Australia, Exercise is Medicine, Nexus Active and Glen Rienecker for any loss, damage or injury that may arise from any person acting on any statement or information contained in the screening tool or the user guide.                                

E-mail: transformed@nexusactive.com

Caboolture, Qld,  Australia

ABN: 21 324 709 841