Pre-exercise Questionnaire Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Date of Birth *GenderHeightWeightCountryCityPhone numberHas your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke? *YesNoDo you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise? *YesNoDo you ever feel faint, dizzy or lose balance during physical activity/exercise? *YesNoHave you had an asthma attack requiring immediate medical attention at any time over the last 12 months? *YesNoIf you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months? *YesNoDo you have any other conditions that may require special consideration for you to exercise? *YesNoDescribe your current physical activity/exercise levels in a typical week by stating the frequency and duration at the different intensities. For intensity guidelines consult figure 2. *How many hours do you sit per day? *What does your weekly schedule look like? *What shoe do you currently use? *What shoes do you mainly wear for day to use? *Please be specific *How many hours do you wear shoes per day? *What system, application or watch do you use to monitor your activity? *What device do you use mainly at home? *Submit