Booty Burn & Beatz Questionnaire

Fields marked with an * are required

Health questionnaire. Please complete in full.

Please read the questions carefully and answer each one honestly selecting the appropriate choice or adding information as necessary. Your answers will be confidential. This form must be completed and assessed by us before you are accepted onto a Boot Camp course.

In the past month have you experienced any chest pains when...

Are you currently taking any medication for...

Once completed, click here to return.