Strong Bones Blueprint Pre-Evaluation Form
Has your doctor cleared you for exercise?
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How did you hear about Strong Bones Blueprint?
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Which days/times could you attend a twice-weekly in-person class?
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Please rate your current level of physical activity.
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Have you experienced any non-traumatic fractures (e.g., a fall from standing height) in the past 5 years?
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Do you have any pre-existing medical conditions that may limit your ability to perform high-load exercises?
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On a scale of 1 to 5, how motivated are you to commit to a regular, structured exercise program?
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Which of the following describes your current pain levels (in general)?
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When would you prefer to start Strong Bones Blueprint?
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Is there anything else we should know regarding your health or fitness before the official assessment?
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Current Height (cm) and Weight
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What is the primary reason you are interested in Strong Bones Blueprint?
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Do you have a current diagnosis of Osteoporosis or Osteopenia?
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Have you had a recent (within the last 2 years) Bone Mineral Density (BMD) scan (e.g., DEXA, REMs scan)?
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Have you had a fall in the past year?
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Are you currently taking a bone-specific medication prescribed by your doctor?
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