The document outlines the importance of pre-exercise checks for gym instructors, including ensuring clients complete a PARQ form and expanding on any answers that indicate potential health issues. It notes instructors must never exercise a client without a completed PARQ, as it identifies contraindications to exercise. Instructors are told to use communication skills to expand on these answers to determine the severity of issues and decide if clients need a doctor referral or are fit to exercise. Examples of expanding questions about medication use are provided, with one client cleared to exercise and another requiring doctor sign-off due to epilepsy.