Health Check-in Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone (###) ### #### 1) - Please answer the following questions. * Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? Yes No 2) - Do you feel pain in your chest when you do physical activity? Yes No Thank you!
