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Sign me up for:	Early Boot Camp Boomer Boot Camp Trial Class January 3rd session February 21st session ASAP
Comments:
Health Screening Mark all TRUE statements If you mark one or more of these statements, please obtain clearance from your physician to participate in this (or any) exercise program.
	You have had: a heart attack heart surgery cardiac catheterization coronary angioplasty (PTCA) pacemaker-implantable cardiac defibrillatory/rhythm disturbance heart valve disease heart failure heart transplantation congenital heart disease
	You experience chest discomfort with exertion You experience unreasonable breathlessness You experience dizziness, fainting, or blackouts You take heart medications You have diabetes You have asthma or other lung disease You have burning or cramping sensation in lower legs when walking short distances You have musculoskeletal problems that limit your physical activity You have concerns about the safety of exercise You take prescription medications You are pregnant Health Screening, Part 2 Mark all TRUE statements If you mark two or more of these statements, please obtain clearance from your physician to participate in this (or any) exercise program. You are a woman 55 years or older You smoke, or quit smoking within last 6 months Your blood pressure is >140/90 mm Hg You do not know your blood pressure You take blood pressure medication Your blood cholesterol level is >200 mg/dL You do not know your cholesterol level You have a close relative who had heart issues before age 55 (dad or bro) or age 65 (mom or sis) You are inactive (less that 30 minutes of activity on at least 3 days/wk) You are more than 20 pounds overweight You experience unreasonable breathlessness