PAR-Q

Physical Activity Readiness Questionnaire

Please complete the following details and PAR-Q – Physical Activity Readiness Questionnaire. This information will be stored electronically for 6 months in a password protected folder for emergency purposes.

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Thank you for your response. ✨

Personal Information

Name

Phone

Date of Birth (DD/MM/YYYY)

Occupation

What are your fitness / training / or injury recovery goals?

What does success look like?

Any major illness or injury in the last 5 years?

Any medical conditions that could impact you taking part in a fitness session?

Any current or historical conditions or injuries that I should be aware of that could impact your ability to exercise?

Emergency Contact

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Emergency Contact Email Address

Medical questions

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.

If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor.

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

In the past month, have you had chest pain when you were not doing physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?

Is your doctor currently prescribing drugs (for example, water pills) for a blood pressure or heart conditions?

Do you know of any other reason why you should not do physical activity?

If you answered YES to one or more of the PAR-Q questions: You should consult with your doctor to clarify that it is safe for you to become physically active at the current time and in your current state of health. If you answered NO to one or more questions: It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level. A fitness appraisal can help determine your ability levels. I have read, understood and accurately completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury. If you have answered YES to one of the questions above and have sought medical advice and your GP has agreed that you may exercise you must sign below.

Signature

Delay Becoming Much More Active
If you are not feeling well because of a temporary illness such as a cold a fever or COVID-19, wait until you feel better; or if you are or may be pregnant, talk to your doctor before you start becoming more active.

Please Note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Disclaimer
You will participate in personal training sessions at your own risk. You confirm that you are fit and healthy with no injuries.