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    • Xtreme Fat Loss Programme
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    • The Resilience Coaching Principles
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Physical Activity Readiness Questionnaire – PARQ

  • Before you start training with me, you must complete this PAR-Q. The information contained within this form will help determine if it is safe for you to do so.
    If there is ever any doubt regarding your fitness to train you should seek advice from your doctor.
    If you or anyone in your household or immediate workplace are showing any of the symptoms of COVID-19 shown below or test positive for COVID-19, you should not attend any in-person sessions and notify me as soon as possible.
    • A new continuous cough
    • Fever/high temperature (37.8C or greater)
    • Loss of, or change in, sense of smell or taste (anosmia)
    A new continuous cough is where you:
    • have a new cough that’s lasted for an hour
    • have had 3 or more episodes of coughing in 24 hours
    • are coughing more than usual
    A high temperature is feeling hot to the touch on your chest or back (you don’t need to measure your temperature). You may feel warm, cold or shivery.
    If you have any more serious symptoms, including pneumonia or difficulty breathing, you should consider contacting the hospital.
    All information you record on this form will be treated with the utmost confidentiality, it will be stored in a secure place and made available to you at any time.   You are not required to provide information on health conditions, however by signing this form you are declaring that there is no health-related reason why you should not, or cannot, exercise.
  • Contact details

  • Date Format: DD slash MM slash YYYY
  • Health assessment

  • Changes in health

  • If you proceed with an exercise and nutrition programme and, during that period, your health changes, please consult your doctor and inform me as soon as possible, as you may need to change or even suspend your physical activity.
  • Exercise history

  • By submitting this form, I confirm and agree to the following:
    • The details I have provided are correct and that I will consult my doctor immediately if anything changes that may affect my ability to exercise or related to my emergency contact details.
    • If I feel light-headed, faint, chest pain, leg cramps, fatigue, discomfort, pain or nausea whilst exercising, then I will immediately stop.
    • To only use equipment which is suitable to my abilities and competencies and will seek advice if I do not know how to correctly use or operate it.
    • If I or someone in my household is showing signs show signs of COVID-19, I will notify my coach immediately.

About The Company
footer-aboutResilience Fitness was founded to help people achieve optimal well-being through individualized exercise and nutrition. The service is bespoke and personal, with no two people coached the same way. My goal is to build a better future for my clients and the people most important to them.
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  • If you're interested in working with me, want more information on my services or simply have a question that you think I might be able to answer, then get in touch using the form below. I'd love to hear from you.

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