Data Protection: Information collected on this form will be treated as confidential and held securely by The Gym. We will use this information to administer and process your membership. Your details will not be passed on to a third party and will be destroyed when the membership is cancelled. We may also use this information to update you about our products and services.

1. Do you suffer from heart disease, high blood pressure or cardiovascular problems?YesNo
2. Is there a history of heart disease in your family?YesNo
3. Has your doctor ever said you have high blood pressure?YesNo
4. Do you ever have pains in your heart and chest after undergoing exertion?YesNo
5. Do you often get headaches, feel faint or dizzy?YesNo
6. Do you suffer from pain or limited movement in any joints or bones? (If so, is this pain aggravated by exercise or might be made worse by it?)YesNo
7. Are you pregnant?YesNo
8. Do you have any other condition which might affect your ability to participate in exercise?YesNo
9. Are you considered a protected adult under the Adult Support and Protection (Scotland) Act 2007? If so, please inform a member of staff.YesNo
10. Are you taking drugs or medication or recuperating from a recent illness or operation which the staff should know about ? YesNo

If you answered YES to one or more questions, please consult your doctor before using this gym and please inform staff.

Please ask their advice as to whether you can undertake unrestricted exercises on both cardiovascular equipment (bikes, steppers and rowers) and resistance machines. Follow your doctor's advice.