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Has your doctor ever said that you have a heart condition OR high blood pressure?


Do you feel pain in your chest at rest, during your daily activities of living, 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 over-breathing (including during vigorous exercise)


Have you ever been diagnosed with another chronic medical condition ( other then heart disease or high blood pressure)?


Are you currently taking prescribed medications for a chronic medical condition?


Do you have a bone or joint problem that could be made worse by becoming more physically active? Please answer NO if you had a joint problem in the past, but it does not limit your current ability to be physically active. For example, knee, ankle, shoulder or other.


Has your doctor ever said that you should only do medically supervised physical activity?