Fitness Lab Booking Form

The below information is required so we can check that the appointment is covered by your insurance policy and so we know exactly what tests are required (on occasion, an appointment with a Doctor is required prior to testing, the below information allows to determine if this is the case). Answers to the questionnaires are secure once submitted and will be added to your patient record if you go ahead with an appointment.

    My health profile

    please take your time answering these questions

    Do you experience*

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    Have you had or do you currently have*

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    Do you currently have pain or any injury that might stop you participating in the Fitness Lab screen*

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo