Exercise Readiness for Children & Adolescents

Exercise Readiness for Children & Adolescents
Gender
Has a GP or AHP referred your child?
Do any of the following medical or physical conditions apply to your child? Tick all that may apply
Is your child currently taking any medications?
In the last 6 months has your child had any of the following (tick all that apply)
Does your child have any chronic disability or illness?
Does your child have difficulty/problems with one or more of the following
Is your child allergic to any foods, medications, pollens or allergens?
Does your child follow a special diet?
Has your child ever been diagnosed with a nutritional deficiency?
Has your child has surgery in the last 12 months?
Informed Consent
I hereby acknowledge that the information provided above regarding my child's health is to the best of my knowledge, correct. I will inform the trainer immediately if there are any changes to the information provided above.