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Part 2 - NoSweat - Policies and Procedures Manual
Extract
NoSweat Academy – Screening and Re-Screening Questionnaire, GP Clearance Request and GP Continuation of Clearance Request User Notes
The first stage of customer service is to ensure that any training programme
does not cause harm. To ensure this, it is important to screen your clients
before any exercise is undertaken. You should be a qualified personal trainer
with the appropriate qualification in personal training, first aid and
the appropriate liability insurance to be responsible for training clients.
The purpose of pre-exercise screening is to identify the small number of
people for whom the benefits associated with participation in regular physical
activity are outweighed by the potential risks.
This screening process follows ACSM guidelines (6th edition) but you should
always check with your insurer about their screening requirements as well.
Screening is a straightforward process and should occur at the point sign
up. This is for two reasons.
1. Immediately conveys to the client that you as a personal trainer are
committed to safety and customer service.
2. Minimises any inconvenience that may occur if the client needs to be
referred to their General Practitioner (GP).
Screening should be carried out on an annual basis, unless specified more frequently by your insurer. All these forms should be kept in the client records file. These should be kept in a secure place as this information is confidential. See later section on annual re-screening.
Completing the Screening Questionnaire
All new clients must complete the 20 item questionnaire (“Screening Questionnaire”) immediately after signing up as a client prior to any physical training with you.
To help your clients to understand the reasons for screening, it should be explained to clients that the first step in starting an exercise programme is ensuring that any exercise they do is safe and therefore I would like to complete a short screening form.
Screening decisions
If any of the items numbered 1-6 or 8-11 have been ticked ‘Yes’ then the client must be referred to their GP prior to any exercise being undertaken with you. You must also look at questions 7, 17 and 18 and decide whether these items require a GP clearance. In order to make decisions like this you should be qualified as a Fitness Instructor/Personal Trainer (e.g ACSM HFI qualification). The GP clearance letter should be completed and given to the member with a prepaid envelope for return back to you by them or the GP. Ensure the client is aware that there will most likely be a charge associated with this process at their GPs surgery. It might be worth finding out the standard charges for this consultation for all the local surgeries. You could also make contact with the surgery and let them know about your screening procedures and so they are ready for these kind of appointments and appreciate you are following established professional guidelines and not referring your clients unnecessarily.
A copy of the client’s completed screening questionnaire should be
stapled to the completed GP Clearance letter. Remember to enclose a SAE
with the GPs letter. The client should be asked to visit their GP and request
that their GP completes the clearance letter that can be returned in person
with the client or posted back to you in the prepaid envelope. The client
can still be booked in for an Initial Consultation with enough time allowed
for them to visit their GP in the meantime. Make sure the client knows
to bring back the letter to the appointment with them or instruct their
GP to post it back to you directly. Ensure the client signs the permission
to release information section of the letter.
If any of the items 12 –16 have been ticked ‘Yes’ and all others are ‘No’ then the member can be booked in for their Initial Consultation and you will have to make decisions on exercise modifications (see later section). If questions 7,17, and 18 are not considered to require GP clearance then also follow these procedures and make the necessary decisions about the exercise prescription (see later section).
If all items have been ticked ‘No’ the client can be booked in for their Initial Consultation and you will have to make decisions on exercise modifications based on the information you have collected. It is important to obtain as much information which would effect the safety of the client as possible at the sign up screening to prevent any delays later on. It is possible that you may get additional information later on at the consultation so be aware of this.
G.P.’s Clearance and Permission to Release Medical Information Form
If the client’s G.P.’s clearance is required you must have
the client complete the Permission to Release Medical Information part
of the GP Clearance Form and include this with the completed questionnaire.
Make sure you complete all the necessary sections of the form before sending
it to the G.P.:
- Print name of the GP.
- Address of the GP.
- Date today.
- Date of screening.
- Dr’s surname name after “Dear Dr____________”.
- Patients (your clients) name.
- Patients (your clients) address.
- Clients name (in Permission section).
- Clients signature (in Permission section).
- Your name.
- Your address.
- Your phone number.
- Sign and print your name at the end.
Keep a copy of the two forms you are sending to the G.P. (Screening Form
and the G.P Clearance/Medical Records Release Form).
Make the client’s clearance visit a hassle-free experience.
It might be worth finding out what sort of appointment clients should ask
for when going to obtain clearance and whether there will be a charge to
the client for this. Also the surgery may say they prefer to have the screening
forms before the client attends the surgery. So make sure your client’s
visit will be problem free, that they wont be surprised with charges they
aren’t ready for and they come away with the clearance they require
to exercise with you.
Exercise Modification
Members who tick ‘Yes’ to 2 or more items numbered 12-16 should be limited to moderate intensity exercise (60% maximum heart rate reserve). Clients who tick one item in 12-16 and they are considered obese they should be limited to moderate intensity exercise. Obesity is defined as BMI of greater than 30 or a waist circumference of greater than 100cm. You do not need to measure these parameters (in case this adds to your client anxiety) but should make educated decisions and work from these. If you are in doubt and other risk factors are present, look at the whole picture when taking body weight as a risk factor into consideration. Clients who tick items 7, 17 or 18 should be reviewed for GP Clearance and appropriate exercise modification.
Male clients aged over 40 and female clients aged over 50 should be limited to moderate intensity exercise.
Failure to Complete Screening
Clients who refuse to complete the Screening Questionnaire will
not be permitted to exercise.
Clients who are requested to gain their GPs clearance and fail to do so when requested to do so will not be permitted to exercise.
Annual Re-Screen Questionnaire
Follow the same procedures as the initial screening. For the annual re-screening
there is an additional question asking about whether the client’s
health status has changed at all since their last screening. You should
indicate the date of the clients last screening in question 1 (which should
have been a maximum of one year ago).
Annual GP Clearance
G.P.’s of clients who was previously were required to obtain GP clearance
must be written to annually to gain clearance. Let the GP’s know
this is what your procedures are so they know that these are re-screens
so they can check their records on re-screen visits to make their task
simpler.
NoSweat Academy – Screening Questionnaire Form 4
Client Name:___________________________________Date:____________
PLEASE READ THE FOLLOWING CAREFULLY AND THEN SIGN AT THE END.
Yes No
1. Has your doctor ever said that you have a heart condition and that you
should only do physical activity recommended by a doctor?
2. Do you have Diabetes Mellitus?
3. Do you feel pain in your chest when you do physical activity?
4. In the past month, have you had chest pain when you were doing
physical activity?
5. Is your doctor currently prescribing drugs for your blood pressure
or heart condition?
6. Do you lose your balance because of dizziness or do you ever lose
consciousness?
7. Do you have a bone or joint problem that could be made worse by
a change in your physical activity or exercise training?
8. Do you suffer shortness of breath at rest or with mild exertion?
9. Do you suffer from unusual fatigue or shortness of breath with
usual activities?
10. Do you get a sharp pain in your lower leg when walking uphill
or upstairs which disappears within 1-2 minutes of stopping?
11. Are you pregnant?
12. Has either your mother, father, brother or sister had a heart attack
or
died suddenly before the age of 55?
13. Has your doctor ever said that you have high blood pressure?
14. Has your doctor said you have raised cholesterol levels?
15. Do you currently smoke cigarettes?
16. Are you inactive (ie no regular exercise at least 3 times per week)
and/or DO NOT work in a job that is physically demanding?
17. Do you take any prescription medications e.g. inhaler for asthma
(apart from contraceptive pill)? If so give details: ____________________________________________________________
18. Do you know of any other reason why you should not do physical activity?
If Yes, please give details:
19. Date of Birth:________________________Age:___________
20. Do you have any questions that you would like answered prior to beginning
exercising?
Yes No
Please tick here when you are happy with the responses to the answers to
your questions
ASSUMPTION OF RISK
I, the undersigned, hereby state that I have read, understood and answered
honestly the questions on this and the previous page. I also state that
I wish to participate in activities which include, but are not limited
to, aerobics, cycling, running and gymnasium exercise (aerobic and resistance)
and stretching exercise. I realise that my participation in these activities
involves the risk of injury and even the possibility of death. Furthermore,
I hereby confirm that I am voluntarily engaging in an acceptable level
of exercise which has been recommended to me. I have had the opportunity
to ask questions prior to exercising and they have been answered to my
satisfaction.
_______________________________ _______________________________
Print Name of Client
_______________________________ _______________________________
Print Name of Trainer Trainer Signed Date
_______________________________ _______________________________
Print Name of Witness Witness Signed Date
Office Use:
Client satisfied with answers to their questions Ÿ
100cm or BMI >30
Risk Stratification LR MR HR 60% HRR maximum
Special Precautions
Dr Letter Required Yes No
If Yes, Date Obtained________ Comments:
