Have you been medically diagnosed with any eating disorder (i.e., anorexia nervosa, anorexia bulimia, binge eating disorder)?*

Have you been diagnosed with any of the following gastrointestinal issues? Diverticulitis, bowel obstructions, bowel resections, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) including ulcerative colitis and/or Crohn’s disease.*

Are you currently taking any prescribed medication for blood pressure, cardiovascular disease or high cholesterol, such as ACE inhibitors, beta blockers, warfarin or statins? *

Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?*

Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?*

Do you ever feel faint, dizzy or lose balance during physical activity/exercise?*

Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?*

If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months?*

Do you have any other medical conditions that may require special consideration for you to participate in this program?*