STEP 1
Print this form. Answer all of the questions by circling 'Yes' or 'No' for each item. Give any special details in the space provided. Sign this form and show it to your physician for approval before starting your personal exercise program.

STEP 2
Select the exercise level that's right for you. It's important to be honest with yourself and choose the right one. There are 3 levels to choose from (novice, intermediate and advanced). Carefully read the panels which describe each level. Which one best describes you?

Level 1 - Novice
I do very little physical exercise, apart from playing golf. I would truthfully rate my present fitness level as below-average.

Level 2 - Intermediate
I do some physical exercise - up to 3 times per week - in addition to playing golf. I would truthfully rate my present fitness level as average.

Level 3 - Advanced
I exercise almost every day - in addition to playing golf. I would truthfully rate my present fitness level as good-excellent.