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Recruit Health History Questionnaire Mobile App

Here are some questions asking in this Recruit Health History Questionnaire. Have you ever suffered a spine, low back, and/or sacroiliac injury? Have you ever suffered a rib, thorax, and/or chest injury? Have you ever suffered a hip, groin, and/or thigh injury? Have you ever suffered a knee injury? Have you ever suffered an ankle, lower leg, and/or foot injury? Have you ever had surgery on your shoulder, elbow / forearm, wrist, hand, and/or finger? Have you ever had surgery on your hip, knee, ankle, lower leg, and/or foot?

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Recruit Health History Questionnaire Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Recruit Name

  • Ico textbox

    Soc.

  • Ico textbox

    Sport

  • Ico date

    Date of Birth

  • Ico checkbox

    Have you ever suffered a head injury / concussion and/or been knocked unconscious?

  • Ico checkbox

    Have you ever suffered a cervical spine / neck injury?

  • Ico checkbox

    Have you ever suffered a shoulder injury?

  • Ico checkbox

    Have you ever suffered a elbow / forearm, wrist, hand, and/or finger injury?

  • Ico checkbox

    Have you ever suffered a spine, low back, and/or sacroiliac injury?

  • Ico checkbox

    Have you ever suffered a rib, thorax, and/or chest injury?

  • Ico checkbox

    Have you ever suffered a hip, groin, and/or thigh injury?

  • Ico checkbox

    Have you ever suffered a knee injury?

  • Ico checkbox

    Have you ever suffered an ankle, lower leg, and/or foot injury?

  • Ico checkbox

    Have you ever had surgery on your shoulder, elbow / forearm, wrist, hand, and/or finger?

  • Ico checkbox

    Have you ever had surgery on your hip, knee, ankle, lower leg, and/or foot?

  • Ico checkbox

    Have you ever had surgery on your spine (cervical / neck, lumbar, etc.

  • Ico checkbox

    Have you ever suffered a heat-related illness and/or received intravenous fluids (IV) for a heat-...

  • Ico checkbox

    Have you ever been diagnosed with any allergies and/or ever had an unfavorable / allergic reactio...

  • Ico checkbox

    Have you ever been diagnosed with asthma and/or exercised induced asthma?

  • Ico checkbox

    Have you ever been diagnosed with diabetes?

  • Ico checkbox

    Have you ever had chest pain and/or unexplained shortness of breath during or after exercise / pr...

  • Ico checkbox

    Have you ever felt dizzy, lightheaded, and/or passed out during or after exercise / practice?

  • Ico checkbox

    Have you ever had the feeling of your heart racing or skipping beats during or after exercise / p...

  • Ico checkbox

    Have you ever been told that you have a heart murmur?

  • Ico checkbox

    Has any family member or relative died of heart problems and/or of sudden death before age 35?

  • Ico checkbox

    Has a physician ever denied or restricted your participation in sports due to any heart problems?

  • Ico checkbox

    Have you ever had an electrocardiogram (EKG) and/or echocardiogram of your heart?

  • Ico checkbox

    Do you have only one of two paired, functioning organs (eyes, kidney, ovary, etc.

  • ...and More!

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