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GCSE PHYSICAL EDUCATION PERSONAL EXERCISE PROGRAMME Name: Robert Evans Form: 11K1 Sport: Cricket Personal Exercise Programme PEP Physical Activity Readiness Questionnaire Health History 1. Have you or a member of your close family had any heart problems? No 2. Do you or have you had high blood pressure? No 3. Do you have increased or high cholesterol? No Medical Conditions 1. Do you have or have you had any chronic illnesses? No 2. Have you had recent surgery (within the last 12 months)? No Respiratory Problems 1. Have you a history of breathing problems, e.g. asthma? No 2. Do you smoke? No Other Concerns 1. Do you have difficulties with regular exercise? No 2. Do you have a muscle or joint disorder? No 3. Do you suffer from diabetes? No Exercise History Tick the box which best describes how active you are. 1 I have never been active in sports or exercise. 2 I used to play sports and take exercise but not now. 3 I am quite active...

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