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Form library · FIT-001

Pre-exercise screening

Example template only. Not legal or clinical advice. Review and adapt before use. Not endorsed by any government agency. Last reviewed 14 October 2026.

Rules differ by state; check yours.

Australian gyms and studios screening an adult before exercise.

Four yes-or-no questions written for this library. A yes answer tells the person to speak to a doctor before they start. It does not clear them to exercise. Fitness records can be health information, so pair it with GEN-002.

Fitness at nopen

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Pre-exercise screening

Example template only. Not legal or clinical advice. Review and adapt before use. Not endorsed by any government agency. Last reviewed 14 October 2026.

DD/MM/YYYY

Do you get chest pain when you are active?
Do you feel dizzy or faint when you are active?
Has a doctor diagnosed a heart condition?
Has a doctor told you to limit exercise?

If you answered yes to any question, speak to a doctor before you start. This form does not clear you to exercise.

Fields

  • Name and date of birth

    Adults. This blank is not a children's screen.

  • Chest pain

    During activity, yes or no.

  • Dizziness

    During activity, yes or no.

  • Heart condition

    Whether a doctor has diagnosed one.

  • Doctor's limit

    Whether a doctor has said to limit exercise.

  • Next step

    Any yes means talk to a doctor before starting.

Questions

Is this an industry-association form?

No. The questions are written for nopen. Do not paste another organisation's screen over the top.

Why is there a state note?

A gym record about a person's health can be health information. Health-records laws are not the same in every state.

State/Territory waivers

Waiver and consent rules differ between states and territories. Check the civil liability law where you operate, and get your own legal advice if you're unsure.

ACTNSWNTQLDSATASVICWA

About these templates

These templates are examples only, to help you get started. They are general information, not legal, medical, clinical or professional advice, and they may not suit your business, your profession or your state or territory.

Before you use any template, you must review and adapt it, and have it checked where needed, so it fits your services, your professional body's rules, privacy and health records laws, and the law where you operate. This matters most for consent, waiver, privacy and minors' forms. You are responsible for the forms you use and the information you collect.

To the extent the law allows, Nopen gives no warranty that the templates are complete, current or fit for any purpose, and is not liable for loss arising from their use. Nothing here excludes, restricts or modifies any right or remedy you have under the Australian Consumer Law that cannot lawfully be excluded.

The templates are not endorsed by or connected with any government agency, including Services Australia, Medicare or the NDIA. Do not add government logos, the Commonwealth Coat of Arms or other official marks to them. Fields that refer to government numbers (such as a Medicare card number) are labels only.

Templates were last reviewed on 14 October 2026. Laws change, so check that a template is current before you rely on it.

Example template only. Not legal or clinical advice. Review and adapt before use. Not endorsed by any government agency. Last reviewed 14 October 2026.

Drafted 14 October 2026.