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STRONK ONBOARDING FORM

CONTACT INFORMATION

BASIC INFORMATION

Which coaching plan are you applying for?
Program Design
Low Contact
High-Contact
Birthday
Day
Month
Year
Gender
Activity Level
What's the highest level that you have competed at in powerlifting?

BACKGROUND & EXPERIENCE

Have you worked with a coach before?
Yes
No
Describe your drinking habits
Describe your smoking habits

Physical Activity Readiness Questionnaire (PAR-Q)


Moderate or vigorous exercise should not be a hazard for most people providing it is undertaken as part of a regular program starting from low intensity and progressing gradually. However, some people will need medical evaluation and advice before starting a program, some may need to exercise under medical supervision and some people may only be able to undertake restricted physical activity under medical supervision.


ANSWER ALL QUESTIONS


If you answer NO to all the questions, it is reasonable for you to assume that you are in a suitable physical condition to start a regular graduated exercise program.


If you answer YES to one or more question you are first advised to consult your doctor prior to participating in any exercise program

Has Your Doctor Ever Said You Have Heart Disease, High Blood Pressure or Any Other Cardiovascular Problem?
Yes
No
Is There a History of Heart Disease in Your Closest Family (Below Age 55)?
Yes
No
Do You Ever Have Pains in Your Heart and Chest, Especially Associated With Minimal Effort?
Yes
No
Do You Lose Your Balance Because of Dizziness or Do You Ever Lose Consciousness?
Yes
No
Do You Have a Bone or Joint Problem That Could Be Made Worse by a Change in Your Physical Activity? (Examples: Back, Hip or Knee)
Yes
No
Is Your Doctor Currently Prescribing Drugs for Your Blood Pressure or Heart Condition?
Yes
No
Are You Taking Drugs / Medication at the Moment or Recuperating From Recent Illness or Operation?
Yes
No
Are You Pregnant?
Yes
No
Are You Unaccustomed to Exercise and Aged Over 50, if a Woman or Over 40, if a Man?
Yes
No
Do You Know of Any Other Reason Why You Should Not Do Physical Activity? (e.g. Diabetes, Epilepsy)
Yes
No

TERMS & CONDITIONS

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