21 Jun

Physical Activity Readiness Questionnaire (PAR-Q)

Many health benefits are associated with regular exercise, and the completion of PAR-Q is a sensible first step to take if you are planning to increase the amount of physical activity in your life.
For most people physical activity should not pose any problem or hazard. PAR-Q is designed to identify the small number of adults for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.
Common sense is the best guide in answering these few questions. Please read them carefully and check the correct answer opposite the question if it applies to you.

If you prefer to print out the form, complete and then return by post or bring on your first session please the form here

 
1. Has your doctor ever said that you have a bone or joint problem, such as arthritis, that has been aggravated by exercise or might be made worse by exercise?  Yes No
2. Do you have high blood pressure?  Yes No
3. Do you have low blood pressure?  Yes No
4. Do you have Diabetes Mellitus or any other metabolic disease?  Yes No
5. Has your doctor ever said you have raised cholesterol (serum level above 6.2mmol/L)?  Yes No
6. Has your doctor ever said that you have a heart condition and that you should do physical activity recommended by a doctor?  Yes No
7. Have you ever felt pain in your chest when you do physical exercise?  Yes No
8. Is your doctor currently prescribing you drugs or medication?  Yes No
9. Have you ever suffered from unusual shortness of breath at rest or with mild exertion?  Yes No
10. Is there any history of Coronary Heart Disease in your family?  Yes No
11. Do you often feel faint, have spells of severe dizziness or have lost consciousness?  Yes No
12. Do you currently drink more than the average amount of alcohol per week (21 units for men and 14 units for women)?  Yes No
13. Do you currently smoke?  Yes No
14. Do you NOT currently exercise on a regular basis (at least 3 times a week) and/or work in a job hat is physically demanding?  Yes No
15. Are you, or is there any possibility that you might be pregnant?  Yes No
16. Do you know of any other reason why you should not participate in a program of physical activity?  Yes No

If you answered:

Yes to one or more questions:

If you have not recently done so, consult with your doctor by telephone or in person before increasing your physical activity and/or taking a fitness appraisal. Tell your doctor what questions you answered 'yes' to on PAR-Q or present your PAR-Q copy. After medical evaluation, seek advice from your doctor as to your suitability for:

  • Unrestricted physical activity starting off easily and progressing gradually, an
  • Restricted or supervised activity to meet your specific needs, at least on an initial basis

No to all questions:

If you answered PAR-Q accurately, you have reasonable assurance of your present suitability for:

  • A graduated exercise program
  • A fitness appraisal

ASSUMPTION OF RISK
I hereby state that I have read, understood and answered honestly the questions above. I also state that I wish to participate in activities that may include aerobic exercise, resistance exercise and stretching. I realise that my participation in these activities involves the risk of injury and even the possibility of death. Furthermore, I hereby confirm that I am voluntarily engaging in an acceptable level of exercise, which has been recommended to me.

Your name


Date


Address


Emergency contact name and number


Your Email address


Your Doctors name and number

Trainers name

Additional Note: I have taken medical advice and my doctor has agreed that I should exercise.
I confirm the detail given are as accurate as possible

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