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Compliment Fitness

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Unique Transformation for a Healthier YOU!!

Physical Fitness Health Waiver

To register to our programs please fill out the following medical form

First Name

Email Address

Last Name

Date of Birth

Do you have a doctor’s permit to participate in intense physical activities?

No

Yes

What is your current activity level?

Sedentary (no exercise)

Lightly Active (1-2 days/week)

Moderately Active (3-5 days/week)

Very Active (6-7 days/week)

Have you lost your consciousness in the last past 12 months?

No

Yes

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Medical Questionnaire

Please fill out the following form to help us understand your physical condition.

First Name

Email Address

Last Name

Date of Birth

Do you have any physical limitations caused by illness or previous physical injury?

No

Yes

Are you currently suffering from a medical condition, illness, or injury?

No

Yes

If you answered yes to any question, please elaborate

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

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