Physical Activity Readiness Questionnaire (PAR-Q)

If you are between the age of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you significantly change your physical and activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor.

Common sense is your best guide when answering these questions.

Please read carefully and answer each one honestly. Tick yes or no.

If in doubt, please tick ‘Unsure’ so that we may discuss.

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?*
Yes
No
Unsure

Do you ever feel pain in your chest when you do physical activity?*
Yes
No
Unsure

In the past month, have you had chest pain when you were not doing physical exercise?*
Yes
No
Unsure

Do you lose balance because of dizziness or do you ever lose consciousness?*
Yes
No
Unsure

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?*
Yes
No
Unsure

Is your doctor currently prescribing medication for your blood pressure or a heart condition?*
Yes
No
Unsure

Do you know any other reason why you should not do physical exericise?*
Yes
No

If yes, please comment?*

Thank you for completing our statutory ParQ form

With the answer you have just provided I need to clarify some details with you before you can continue with your registration.

After you click submit, you will be redirected to a page where you can request a call with Rob. He will be able to discuss how best to get you online in the classes as quick as possible.

Declaration
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 risk of injury.

This is your electronic signature, only tick if you agree.

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Physical Activity Readiness Questionnaire (PAR-Q)