Have you ever suffered from heart trouble? *

Do you suffer from chest pains? *

Do you suffer from chest pains? *

Do you ever have spells of dizziness or feel faint? *

Have you ever had either high or low blood pressure, and/or high cholesterol level? *

Have you ever had asthma, chronic bronchitis or any other chest ailments? *

Do you suffer from severe back pains or any orthopaedic problem? *

Do you suffer from severe headaches or migraines? *

Are you recuperating from a recent illness/operation or injury? *

Is there any history of heart disease in your immediate family (under the age of 55)? *