Name

First Name

Last Name

*

Do you have a confirmed medical diagnosis of multiple sclerosis (MS)?

Yes

No

*

Have you had a bone fracture in the last 3 months?

Yes

No

*

Are you willing to commit to attending an on-site exercise program twice-weekly for 12 months?

Yes

No

*

Are you able to:* (select only what you can do without assistance from specialised equipment)

Bend down and pick up a basket of washing

Lift your arms above your head to hang a pair of jeans on the line

Sit down and stand up from a chair without holding anything to steady yourself most of the time