Pre-Participation Questionnaire for:

Medical Clearance

Answer the following question to determine your need for Medical Clearance.
Question 1:
​CURRENT SYMPTOMS
​​1. Have you been experiencing any of the symptoms listed below?
  • Chest Discomfort with or without exertion
  • Unreasonable Breathlessness (Shortness of Breath)
  • Dizziness, Fainting, or Blackouts
  • Ankle Swelling
  • Forceful, rapid, or irregular heart beats (Palpitations)
  • Burning or cramping in your calves when walking