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1. Do you have any preexisting injuries (ankles, knee, back, neck, etc,)? *
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2. Are you currently taking any medications? *
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3. Do you have a history of heart problems or are you taking heart medication? *
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4. Do you have high blood pressure or a history of high blood pressure? *
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5. Do you have any allergies? (food, bees, insects, medications, etc.) *
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Are you carrying an epi-pen or other allergy medication today?
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6. Do you have asthma? *
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Are you carrying an inhaler with you today?
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7. Do you have diabetes? *
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8. Do you have any other physical limitations? *
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9. Current level of activity at home. *
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I understand this is a legal representation of my signature.
Clear
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I understand this is a legal representation of my signature.
Clear
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