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Medical Questionnaire

Please fill out the following form to help us understand

your physical condition.

First Name

Email Address

Last Name

Date of Birth

Do you have any health or medical problems? Eg: heart issues, asthma, high blood pressure *

No

Yes

Do you have any injuries, conditions or recent surgeries that may effect your movements in any way? *

No

Yes

If you answered yes to any question, please elaborate

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

South Plaza

Discovery Bay

Email

info@thebeat.com.hk

Connect

Wong Chuk Hang
S22, Unit A, 5/F, 22 Heung Yip Rd

Phone | WhatsApp

+852 5721 3000

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