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  • Membership Start Date*
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  • Date of Birth*
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  • Emergency Contact

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  • Pre Exercise Questionnaire

  • Disclaimer
    This questionnaire is not designed to provide medical advice, and should not be considered to do so. All content available on or through this tool is for general information purposes only.
    The provider of this questionnaire is not responsible or liable for any advice, course of treatment, diagnosis or any other information, services or products that you obtain through this service.

    Notice to the user
    You are encouraged to consult your doctor with regard to information contained in or revealed through this questionnaire. Never disregard professional medical advice, or delay in seeking it, because of the outcome you have received as a result of this assessment.
    This questionnaire will tell you whether it is necessary for you to seek further advice from your doctor OR a qualified exercise professional before becoming more physically active.

  • Has your doctor ever told you that you have a heart condition OR high blood pressure?*
  • Do you feel pain in your chest at rest, during your daily activities OR when you do physical activity?*
  • Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with hyperventilation (including during vigorous exercise).*
  • Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?*
  • Are you currently taking prescribed medications for a chronic medical condition?*
  • Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.*
  • Has your doctor ever told you that you should only take part in medically-supervised physical activity?*

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      6x6 Membership Aquadome

      6x6 Membership Aquadome

      $620.00 AUD$620.00AUD
        
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