PAR-Q - Physical Activity Readiness Questionnaire (PAR-Q)

Physical Activity Readiness Questionnaire (PAR-Q)

Please complete this form before commencing training, it is used to assess that it is safe for you to change physical activity levels.

Full Name*

Date of Birth*

Date of Birth

Height*

Weight*

Birth Specified Gender*

Self Identified Gender*

Phone Number*

Being more active is very safe for most people, and for most should not pose any problems or hazard. However, some people should check with their doctor before they start becoming much more physically active.

Physical Activity Readiness Questions - please indicate if any of these conditions apply.

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
Do you feel pain in your chest when you perform physical activity?
In the past month, have you had chest pain when you were not performing any physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?
Do you know of any other reason why you should not engage in physical activity?

If you have checked any of the above questions consult your GP before engaging in physical activity. tell your GP which conditions you have experienced. After a medical evaluation, seek advice from your GP on what type of activity is suitable for your current condition. If your condition changes throughout the exercise program such that you experience any of the above conditions consult your GP before continuing and inform your coach.

I have read, understood, and completed this questionnaire to the best of my knowledge. I understand that I am responsible for monitoring my own physical condition throughout the exercise program and should any unusual symptoms occur, I would cease my participation and notify my coach of the symptoms and seek advice from a medical professional.

Signed*

Date*

Date

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