Health & Training History Questionnaire PAR-Q

(Physical Activity Readiness Questionnaire)

Physical activity has a number of both physical and mental health benefits. It is safe for most people to take part in physical activity but not for all. This questionnaire aims to identify those who, if they increase the intensity of their physical activity, could be at risk of a health complication.

If it is found that you could be in this at-risk population then you should check with your doctor first before undertaking your new training regime.

Please answer the following questions as honestly as possible. If you have answered yes to any of the following questions and are not used to being very active then you must check with your doctor.

Personal Details

Full Name

Age

Mobile Number

Emergency Contact Name

Emergency Contact Number

Health Questions

Have you ever been diagnosed with a heart condition and been told that you should only do physical activity recommended by a doctor?

Do you or have you ever felt pain in your chest when you have done physical activity?

In the past month have you experienced chest pains when you were not doing physical activity?

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

Do you suffer from a bone or joint condition that could be affected by an increase in physical activity?

Are you currently on any medication? If yes, please specify?

Do you know of any other reasons why you should not be taking part in physical activity?

How active would you say you are?

What training and exercise experience do you have?

How did you hear about us?

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PAR-Q

Health & Training History Questionnaire PAR-Q

(Physical Activity Readiness Questionnaire)

Personal Details

Health Questions

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