1. Has your doctor ever said that you have a heart condition or high blood pressure? *

2. Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity? *

3. Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise). *

4. Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure? *

5. Are you currently taking prescribed medications for a chronic medical condition? *

6. Do you currently have or have had within the past 12 months, a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? (Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.) *

7. Has your doctor ever said that you should only do medically supervised physical activity? *

1. Do you have Arthritis, Osteoporosis, or Back Problems? *

1a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

1b. Do you have joint problems causing pain, a recent fracture or fracture caused by osteoporosis or cancer, displaced vertebra (e.g., spondylolisthesis), and/or spondylolysis/pars defect (a crack in the bony ring on the back of the spinal column)? *

1c. Have you had steroid injections or taken steroid tablets regularly for more than 3 months? *

2. Do you currently have Cancer of any kind? *

2a. Does your cancer diagnosis include any of the following types: lung/bronchogenic, multiple myeloma (cancer of plasma cells), head, and/or neck? *

2b. Are you currently receiving cancer therapy (such as chemotherapy or radiotherapy)? *

3. Do you have a Heart or Cardiovascular Condition? This includes Coronary Artery Disease, Heart Failure, Diagnosed Abnormality of Heart Rhythm *

3a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

3b. Do you have an irregular heart beat that requires medical management? (e.g., atrial fibrillation, premature ventricular contraction) *

3c. Do you have chronic heart failure? *

3d. Do you have diagnosed coronary artery (cardiovascular) disease and have not participated in regular physical activity in the last 2 months? *

4. Do you currently have High Blood Pressure? *

4a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

4b. Do you have a resting blood pressure equal to or greater than 160/90 mmHg with or without medication? (Answer YES if you do not know your resting blood pressure) *

5. Do you have any Metabolic Conditions? This includes Type 1 Diabetes, Type 2 Diabetes, Pre-Diabetes *

5a. Do you often have difficulty controlling your blood sugar levels with foods, medications, or other physician prescribed therapies? *

5b. Do you often suffer from signs and symptoms of low blood sugar (hypoglycemia) following exercise and/or during activities of daily living? Signs of hypoglycemia may include shakiness, nervousness, unusual irritability, abnormal sweating, dizziness or light-headedness, mental confusion, difficulty speaking, weakness, or sleepiness. *

5c. Do you have other metabolic conditions (such as current pregnancy-related diabetes, chronic kidney disease, or liver problems)? *

5d. Are you planning to engage in what for you is unusually high (or vigorous) intensity exercise in the near future? *

6. Do you have any Mental Health Problems or Learning Difficulties? This includes Alzheimer’s, Dementia , Depression, Anxiety Disorder, Eating Disorder, Psychotic Disorder, Intellectual Disability, Down Syndrome *

6a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

6b. Do you have Down Syndrome AND back problems affecting nerves or muscles? *

7. Do you have a Respiratory Disease? This includes Chronic Obstructive Pulmonary Disease, Asthma, Pulmonary High Blood Pressure *

7a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

7b. Has your doctor ever said your blood oxygen level is low at rest or during exercise and/or that you require supplemental oxygen therapy? *

7c. If asthmatic, do you currently have symptoms of chest tightness, wheezing, laboured breathing, consistent cough YES O NOD (more than 2 days/week), or have you used your rescue medication more than twice in the last week? *

7d. Has your doctor ever said you have high blood pressure in the blood vessels of your lungs? *

8. Do you have a Spinal Cord Injury? This includes Tetraplegia and Paraplegia. *

8a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

8b. Do you commonly exhibit low resting blood pressure significant enough to cause dizziness, light-headedness, and/or fainting? *

9. Have you had a Stroke? This includes Transient lschemic Attack (TIA) or Cerebrovascular Event. *

9a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments) *

9b. Do you have any impairment in walking or mobility? *

9c. Have you experienced a stroke or impairment in nerves or muscles in the past 6 months? *

10. Do you have any other medical condition not listed above or do you have two or more medical conditions? *

10a. Have you experienced a blackout, fainted, or lost consciousness as a result of a head injury within the last 12 months OR have you had a diagnosed concussion within the last 12 months? *

10b. Do you have a medical condition that is not listed (such as epilepsy, neurological conditions, kidney problems)? *

10c. Do you currently live with two or more medical conditions? *