Curious about joining the Attak Squad? Welcome!

Pre-Exercise Questionnaire 

Current medical conditions

I have NO pre-existing or current medical conditions that would impact me to exercise safely. 

I HAVE:

High blood pressure

Heart conditions or any cardiovascular conditions

Suffered a stroke

History of coronary heart disease in your family 

High cholesterol 

Major illness or surgery in last 5 years

Dizziness, felling faint, or blackouts during exercise 

Hernia in the last 12 months

Asthma requiring medical attention in the last 12 months

Epilepsy 

Diabetes and having trouble controlling your blood glucose in the last 6 months

Currently on prescribed medication that may hinder your ability to safely exercise

Pregnant or have given birth in last 8 weeks

Arthritis or other joint/macular pain  

Other

I, {name} at {address} acknowledge that I have read and agree to all of the information on this document and that all information provided is true and correct.  I acknowledge that I will not have any claim or action of any kind against Base Attak or related entities or any of its staff or contractors for any illness, injury or adverse change in medical condition or state of health arising directly or indirectly from any exercise program or services I undertake at Base Attak. I will inform management at Base Attak if I develop any health or medical conditions that impact my ability to exercise safely. 

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