CFIF

CF:IF Medical Evaluation Form
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Question 1
Do you currently exercise?*

YESNO
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?*

YESNO
why?

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

YESNO
What?

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

YESNO
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: