AlexWellnessDay – Mkhwane SS Biokineticist

Name *

First

Last

Running Club *

Email *

How Long have you been running regularly

How many km's do you run per week

Have you had any previous illness/ surgery that might affect your ability to run? *

Have you ever been diagnosed with a heart condition or cardiovascular disease? *

Are you currently experiencing any chest pain or discomfort during exercise? *

Do you ever feel dizzy or faint during or after exercise? *

Do you have a history of asthma or exercise-induced bronchoconstriction? *

Do you experience wheezing, coughing, or shortness of breath during exercise? *

Are you currently experiencing any pain, discomfort, or injuries that affect your ability to run? *