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Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?

Do you feel pain in your chest when you perform physical activity?

In the past month, have you had chest pain when you are not performing any physical activity?

Do you lose your balance because of dizziness, or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?

Do you know of any other reason why you should not engage in physical activity?

Have you ever had any pain or injuries (ankles, knees, hips, back, shoulders, etc.)?

Have you ever had any surgeries?

Has a medical doctor ever diagnosed you with a chronic disease, such as coronary heart disease, coronary artery disease, hypertension, high cholesterol or diabetes?

Are you currently taking any medication?

Does your occupation require extended periods of sitting?

Does your occupation require extended periods of repetitive movements?

Does your occupation require you to wear shoes with high heels?

Does your occupation cause you anxiety or stress?

Do you partake in any recreational activities?

Do you have any hobbies?