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Health Questionaire Clarification

If an applicant responds "YES" to any of the question on the health questionnaire, the test administrator should clarify this information with the applicant.  If the answer is still yes, check with the individual's or company's physician.

Are you presently restricted from lifting or pulling by any physician? Have you ever had a blood clot?
Have you recently had any surgery which should limit your lifting or pulling? Do you currently have an infection?
Are you presently placed on medical limitations by your employer or doctor? Do you currently have an uncontrolled metabolic disease (diabetes, thyrotoxicosis, gout, myxedema, etc) or serious disorder (mononucleosis, hepatitis, etc.)?
Has your doctor ever said you have heart trouble? Has your doctor ever told you that you have a bone or joint problem, such as arthritis that has been aggravated or might be made worse by exercise?  (Neuromuscular, musculoskeletal, rheumatoid arthritis or bone spur)
Are you having back pain? Are you currently taking any prescription or non-prescription medication?  If yes, what and when last taken?
Do you have high blood pressure (greater than 140/90)? Are you currently experiencing asthmatic symptoms with exercise?  If "YES" are you on daily medication and if so, what an when last taken?
Have you recently experienced chest discomfort with exertion or shortness of breath for no apparent reason? Are you pregnant?
Do you often feel faint or have spells of severe dizziness? Is there a good physical reason not mentioned here why you should not perform these tests even if you wanted to?

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Are you presently restricted from lifting or pulling by any physician?
If the applicant has any restrictions at this time, they will require an AEI doctor's release form signed by a physician prior to testing.

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Have you recently had any surgery which should limit your lifting or pulling?
Emphasize that it must limit their ability to lift or pull.  If this is the case, they are probably under a doctor's care and would have answered "YES" to question #1.  They will require an AEI doctors release form signed by a physician prior to testing.

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Are you presently placed on medical limitations by your employer or doctor?
If the applicant is on any medical limitations at this time, they will require an AEI doctor's release form prior to testing.

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Has your doctor ever said you have heart trouble?
If they know they have disabling heart disease, do not perform the test and get an AEI doctor's release form signed by a physician prior to testing.  If they have been told they have a heart murmur, assume the condition is benign and would present no problems UNLESS they have been told by a physician to restrict their activities.  This will require an AEI doctor's release form signed by a physician prior to testing.  If they claim to have an 'irregular' heart beat AND if the heart monitor is unable to provide a consistent heart rate while resting, an alternative test may be necessary.  Contact AEI for further instructions.  If they claim to have an 'irregular' heart beat AND the heart monitor will pick up the heart rate while resting, you may perform the test.

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Are you having back pain?
If they are not having pain as you are talking to them but either woke up with pain that morning or have had chronic pain which just happens to be absent at present, they will need an AEI doctor's release form signed by a physician prior to testing.  If they have had recent back pain from exertion or a pulled muscle, but are no longer having pain, proceed with test.

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Do you have high blood pressure (greater than 140/90)?
Blood pressure will be taken as part of the test.  Anything greater than 140 or 90 (systolic/diastolic) is widely held to be hypertensive, and will require an AEI doctor's release form signed by a physician prior to testing, even if the blood pressure is being controlled by medication.  *This cutoff is more conservative than the ACSM, so the applicant is not at any undue risk of injury.  This also falls under the World Health Organization guidelines*.  DO NOT do the test if blood pressure is greater than 200/115 even if you have the physicians approval.

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Have you recently experienced chest discomfort with exertion or shortness of breath for no apparent reason?
Any pain, discomfort, sensations of pressure or tightness expressed, will require an AEI doctor's release form signed by a physician prior to testing.  Shortness of breath due to physical activity (panting) would not contraindicate the test.

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Do you often feel faint or have spells of severe dizziness?
If yes, they will need an AEI doctor's release form signed by a physician prior to testing.  

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Have you ever had a blood clot?
If the blood clot was non-traumatic in origin (not the result of an injury), they will need an AEI doctor's release form signed by a physician prior to testing.  If the blood clot was from an injury or there was a cause (pregnancy for example) and the blood clot has dissolved, you can proceed with the test. 

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Do you currently have an infection?
If a person has a fever, they may have an elevated heart rate;  the test must be rescheduled until the fever has subsided.  A common cold would likely not be limiting, but severe bronchitis, upper respiratory, or pneumonia might.  If this is the case, testing should be postponed.  Infections in hands, teeth, feet or urinary tract should not require rescheduling, unless the infection is painful or limits their ability to step or lift.

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Do you currently have an uncontrolled metabolic disease (diabetes, thyrotoxicosis, gout, myxedema, etc) or serious disorder (mononucleosis, hepatitis, etc.)?
If yes, the applicant will need an AEI doctor's release form signed by a physician prior to testing. 

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Has your doctor ever told you that you have a bone or joint problem, such as arthritis that has been aggravated or might be made worse by exercise?  (Neuromuscular, musculoskeletal, rheumatoid arthritis or bone spur)
If the participant has chronic arthritis that does not limit their activities and they are not having a flare-up, interpret this question as a "NO" and proceed with the test.  If they are having a flare-up, but the  arthritis does not limit their activities, reschedule the appointment.  If their activities are limited the applicant will need an AEI doctor's release form signed by a physician prior to testing. 

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Are you currently taking any prescription or non-prescription medication?  If yes, what and when last taken?
In general, all blood pressure medications require an AEI doctor's release form signed by a physician prior to testing.  For any other medications, check the medication listing provided in your clinic master pack and manual.  If the medication is not on this listing contact AEI Testing Department for further instructions.
NOTE:  Regardless of whether the medication requires physician approval, it is imperative that all medications be documented on the data sheet, under the comments section.

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Do you have asthma?  If "YES" are you on daily medication and if so, what and when last taken?
A signed physicians release form is not required for asthma unless it is limiting to the applicant;  however, if they are having an attack you may need to reschedule the test for another time.  If the asthma limits their activities, they will need an AEI doctor's release form signed by a physician prior to testing.

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Are you pregnant?
Pregnancy in any stage requires a physicians approval prior to testing.  The test can be taken 6 weeks postpartum with an AEI doctor's release form signed by a physician. 

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Is there a good physical reason not mentioned here why you should not perform these tests even if you wanted to?
If so, they will need an AEI doctor's release form signed by a physician prior to testing.  Cold, flu or fatigue would generally not require a physicians signed release form, though it may be beneficial to postpone testing.