CFIF

CF:IF Medical Evaluation Form
Name *

First Name Last Name
E-mail *
Address *

Street Address

Street Address Line 2

City

Country

Question 1
Do you currently exercise? *

YES NO
Over the last month, how many times a week have you exercised?
On average how long do these sessions last?
Average minutes per session
Physical Activity Vital Sign

Question 4
Has a doctor ever told you not to participate in vigorous physical activity? *

YES NO
why?

Question 5
Do you have any muscular or skeletal issues that limit or restrict your participation in physical activity? *

YES NO
What?

Question 6
Do you have any other reason that you think should restrict your participation in physical activity? *

YES NO
What?

CF:IF Medical Evaluation Form
Congrats!! you are fit to start unrestricted participation at IslandFit.
Someone will be contacting you soon to discuss the need for you to get medical clearance
Enter the message as it's shown *
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm