I also agree with the above comments, when a client mentions that he or she has had health issues in the past, aside from the liability of the clients well being, you must understand the full scope of the health situation. As a personal trainer it is your job to get as much of an understanding about the patients health as possible, so that you can make the decisions that can impact that clients health. If a client is not going to adhere to the standards as set out but the medical professional then it probably would not be a choice in my eyes! A client absolutely must have clearance from physician in order to participate in any exercises if there are past health issues. Otherwise you are placing yourself as well as your client at rick!!!