Health Questionaire

Prior to pool entry, we ask that you complete this simple health questionaire to help us rule out any contraindications.

Condition
Yes No Comment
Do you suffer from a heart condition?
     
Do you have blood pressure issues? Is it controlled by medication?
     
Have you suffered from recent stroke?
     
Do you have neurological disorders? Such as Epilespy, Parkinsons disease, Cerebral palsy, Multiple Scerlosis?
     
Do you have any kidney problems?
     
Are you affected by dizzy spells or fainting?
     
Are you Pregnant?
     
Do you have any breathing problems? I.e Asthma?
     
Do you have any skin conditions such as dermitis, tinea?
     
Do you currently have a middle ear infection?
     
Do you have any form of cancer?
     
Do you have any bladder or bowel problems? (Incontinence)
     
Have you recently had surgery?
     
Do you currently have any open wounds, sore or sutures?
     
Is there anything else we should know?