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Pre-Participation Screening
Symptoms
Question:
Do you experience
an
y of the following SYMPTOMS?
Chest Discomfort
(with or without exertion)
Unreasonable Breathlessness
Dizziness, Fainting, Blackouts
Ankle Swelling
Forceful, Rapid, or Irregular Heart Beats
Burning or Cramping in Calves when Walking
No
Yes