Performance Questionnaire

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor.
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.

Type your name here to acknowledge that if you selected "Yes" to any of the above you should consult with a medical professional before starting a physical activity program. *

Goals & Schedule

Equipment

Improvement & Drive

Please Initial: I understand that I am assuming all risks associated with starting this training program and have been cleared by a medical professional for physical activity. *

Please Initial: I understand that Bomenclature LLC (dba The Lifelong Athlete) operates under a 30-day cancellation notice for 1:1 online training services. *