History of a heart problem (ie chest pain, heart murmrur or stroke)DiabetesAsthma, breathing or lung problemsAllergiesCancerSeizures, neurological problems, dizzinessHigh blood pressureBack problems, joint or muscle disorder still affecting youRecent surgery
Hernia or any condition that may be aggravated by exercise)Physician's advice not to exerciseHistory of high cholesterolDo you smokeDo you consume alcoholDo you take supplements of any kindAre you on any medicationDo you have joint problems that might be aggravated by exerciseIs stress from daily living an issue in your life
On a scale of 1-10 please indicate how important it is for you to achieve this goal?12345678910
How many times a day do you eat? 123456+
How many Litres of water do you consume per day?
Describe a typical day of the food you would consume:
How many times a week do you currently exercise?
