Physical Activity Readiness Questionnaire Please complete the following form, prior to starting your training journey with us. Name * First Name Last Name Email Age Do you have any health or fitness goals you would like to achieve? If yes, please describe these below Do you have any gym training experience? if so please give a brief description below. 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? * YES NO 2. Do you feel pain in your chest when you do physical activity? * YES NO 3. In the past month, have you had chest pain when you were not doing physical activity? * YES NO 4. Do you lose your balance because of dizziness or do you ever lose consciousness? YES NO 5. Do you have a bone or joint problem that could be made worse by a change in your physical activity? * YES NO 6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? * YES NO 7. Do you know of any other reason why you should not do physical activity? * YES NO PAR Q RESULTS * If You Answered Yes Answer Yes to any of these and it is recommended that you consult a physician before taking a fitness test or substantially increasing your physical activity. Ask for medical clearance along with information about specific exercise limitations you may have. In most cases, you will still be able to do any type of activity you want as long as you adhere to some guidelines. When to Delay an Exercise Program • If you are not feeling well because of a temporary illness, such as a cold or a fever, wait until you feel better to begin exercising. • If you are or may be pregnant, talk with your doctor before you start becoming more active. If You Answered No If you answered No to all the PAR-Q questions, you can be reasonably sure that you can exercise safely and have a low risk of having any medical complications from exercise. It is still important to start slowly and increase gradually. Keep in mind that if your health changes so that you then answer "Yes" to any of the PAR-Q questions, tell your fitness or health professional. You may need to change your physical activity plan. I understand Further Information If you would like to tell us anything regards to your health, fitness, goals or anything you feel we need to know, please add it here. Thank you!
