Health Check - Stronger You

Stronger You Health Check

Prepare to become more active. Please answer the following questions to help us ensure that you have a safe physical activity experience.

Your privacy is important to the Association. We are dedicated to protecting the privacy and confidentiality of all your personal information. We ask for your personal information to be able to serve you better.

* Indicates required field

Name *

First

Last

Email *

Have you experienced any of the following within the past 6 months (Check all that apply): *

A diagnosis of/treatment for heart disease or stroke, pain/discomfort/pressure in your chest during activities of daily living or during physical activity. A diagnosis of/treatment for high blood pressure (BP) or a resting BP of 160/90 or higher. Dizziness or light-headedness during physical activity. Shortness of breath at rest. Loss of consciousness/fainting for any reason. Concussion Do you have acute pain or swelling in any part of your body (such as from an injury, acute flare-up of arthritis or back pain) Has your healthcare provider told you that you should avoid or modify certain types of physical activity? Do you have any other medical or physical conditions (such as diabetes, cancer, osteoporosis, asthma, spinal cord injury) that may affect your ability to be physically active?

If applicable, please provide any additional information about your answers to the previous questions *

Is there anything else that may impact your physical activity? *

Submit