Follow-up questions about your medical condition(s)

Follow-Up Questions About Your Medical Condition(s)

1. Do you have Arthritis, Osteoporosis, or Back Problems?

YES ☞ Answer questions 1a-1c NO ☞ Go to question 2

1 a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments.)

YES NO

1 b. Do you have joint problems causing pains recent fracture or fracture caused by osteoporosis or cancer, displaced vertebra (e.g. spondylolisthesis), and/or spondylolysis/pars defect (a crack in the bony ring on the back of the spinal column)?

YES NO

1 c. Have you had steroid injections or taken steroid tablets regularly for more than 3 months?

YES NO

2. Do you currently have Cancer of any kind?

YES ☞ Answer questions 2a-2b NO ☞ Go to question 3

2 a. Does your cancer diagnosis include any of the following types: lung/bronchogenic, multiple myeloma (cancer of plasma cells), head, and/or neck?

YES NO

2 b. Are you currently receiving cancer therapy (such as chemotherapy or radiotherapy)?

YES NO

3. Do you have a Heart or Cardiovascular Condition? This includes Coronary Artery Disease, Heart Failure, Diagnosed Abnormality of Heart Rhythm.

YES ☞ Answer questions 3a-3d NO ☞ Go to question 4

3 a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)

YES NO

3 b. Do you have an irregular heart beat that requires medical management? (e.g., atrial fibrillation, premature ventricular contraction)

YES NO

3 c. Do you have chronic heart failure?

YES NO

3 d. Do you have diagnosed coronary artery (cardiovascular) disease and have not participated in regular physical activity in the last 2 months?

YES NO

4. Do you currently have High Blood Pressure?

YES ☞ Answer questions 4a-4b NO ☞ Go to question 5

4 a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)

YES NO

4 b. Do you have a resting blood pressure equal to or greater than 160/90 mmHg with or without medication? (Answer YES if you do not know your resting blood pressure)

YES NO

5. Do you have any Metabolic Conditions? This include Type 1 Diabetes, Type 2 Diabetes, Pre-Diabetes

YES ☞ Answer questions 5a-5e NO ☞ Go to question 6

5 a. Do you have difficulty controlling your blood sugar levels with foods, medications, or other physician-prescribed therapies?

YES NO

5 b. Do you often suffer from signs and symptoms of low blood sugar (hypoglycaemia) following exercise and/or during activities of daily living? Signs of hypoglycaemia may includes shakiness, nervousness, unusual irritability, abnormal seating, dizziness or light-headedness, mental confusion, difficulty speaking, weakness, or sleepiness.

YES NO

5 c. Do you have any signs or symptoms of diabetes complications such as heart or vascular disease and/or complications affecting your eyes, kidneys, OR the sensation in your toes and feet?

YES NO

5 d. Do you have other metabolic conditions (such as current pregnancy-related diabetes, chronic kidney disease, or liver problem)?

YES NO

5 e. Are you planning to engage in what for you is unusually high (or vigorous) intensity exercise in the near future?

YES NO

6. Do you have any Mental Health Problems or Learning Difficulties? This includes Alzheimer's, Dementia, Depression, Anxiety Disorder, Eating Disorder, Psychotic Disorder, Intellectual Disability, Down syndrome.

YES ☞ Answer questions 6a-6b NO ☞ Go to question 7

6 a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)

YES NO

6 b. Do you have Down syndrome AND back problems affecting nerves or muscles?

YES NO

7. Do you have a Respiratory Disease? This include Chronic Obstructive Pulmonary Disease, Asthma, Pulmonary High Blood Pressure.

YES ☞ Answer question 7a-7d NO ☞ Go to question 8

7a. Do you have issue controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)

YES NO

7 b. Has your doctor ever said your blood oxygen level is low at rest or during exercise and/or that you require supplemental oxygen therapy?

YES NO

7 c. If asthmatic, do you currently have symptoms of chest tightness, wheezing, laboured breathing, consistent cough (more than 2 days/week), or have you used your rescue medication more than twice in the last week?

YES NO

7 d. Has your doctor ever said you have high blood pressure in the blood vessels of your lungs?

YES NO

8. Do you have a Spinal Cord Injury? This include Tetraplegia and Paraplegia

YES ☞ Answer question 8a-8c NO ☞ Go to question 9

8 a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)

YES NO

8 b. Do you commonly exhibit low resting blood pressure significant enough to cause dizziness, light headedness, and/or fainting?

YES NO

8 c. Has your physician indicated that you exhibit sudden bouts of high blood pressure (know as Autonomic Dysreflexia)?

YES NO

9. Have you had a Stroke? This includes Transient Ischemic Attack (TIA) or Cerebrovascular Event.

YES ☞ Answer question 9a-9c NO ☞ Go to question 10

9 a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)

YES NO

9 b. Do you have any impairment in walking or mobility?

YES NO

9 c. Have you experienced a stroke or impairment in nerves or muscles in the past 6 months?

YES NO

10. Do you have any other medical condition not listed above or do you have two or more medical conditions?

YES ☞ Answer questions 10a-10c NO ☞ Go to recommendations

10 a. Have you experienced a blackout, fainted or lost consciousness as a result of a head injury within the last 12 months OR have you had a diagnosed concussion within the last 12 months?

YES NO

10 b. Do you have a medical condition that is not listed (such as epilepsy, neurological conditions, kidney problems)?

YES NO

10 c. Do you currently live with 2 or more medical conditions?

YES NO

Please list your medical condition(s) and any related medications here:

First Name

Last Name

If you answered NO to all of the FOLLOW-UP questions about your medical condition, you are ready to become more physically active.

If you answered YES to one or more of the FOLLOW-UP questions about your medical condition, you should seek further information before becoming more physically active or engaging in a fitness appraisal.

If you have a temporary illness such as a cold or fever; it is best to wait until you feel better.

If you are pregnant, talk to your health care practitioner, your physician or a qualified exercise professional before becoming more physically active.

If your health changes, talk to your doctor or qualified professional before continuing with any physical activity program.

Follow-Up Questions About Your Medical Condition(s)

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