Language
  • English (UK)
  • Welcome sheet - Client Information

    We are committed to protecting your privacy when you use our services. We will make sure any and all details held (on paper and/or electronically) will be stored securely.
  •  -  - Pick a Date
  •  -
  •  -
  • PAR-Q+ (Physical Activity Readiness Questionnaire)

    The Physical Activity Readiness Questionnaire for Everyone
  • Regular physical activity can be fun and healthy, and more people can benefit from becoming more physically active, every day of the week.

    Being more physically active is safe for MOST people.

    This questionnaire will tell you whether it is necessary
    for you to seek further advice from your doctor OR a qualified exercise professional before becoming more physically active.

     

  • SECTION 1 - GENERAL HEALTH

    Please read the 7 questions below carefully and answer each one honestly: check YES or NO
  •  
  • If you answered NO to all of the questions above, you are cleared for physical activity.


    › Start becoming much more physically active – start slowly and build up gradually.
    › Follow the American College of Sports Medicine Guidelines
    › You may take part in a health and fitness appraisal.
    › If you have any further questions, discuss this with your personal trainer).
    › If you are over the age of 45 yrs. and NOT accustomed to regular vigorous physical activity,
    please consult a qualified exercise professional before engaging in maximal effort exercise.


    If you answered YES to one or more of the questions above, please contact me here for further instructions.


    Delay becoming more active if:
    › You are not feeling well because of a temporary illness such as a cold or fever – wait until you
    feel better
    › You are pregnant – talk to your health care practitioner, your physician, a qualified exercise
    professional, and/or complete the PARmed-X for Pregnancy before becoming more physically
    active OR
    › Your health changes – please answer the questions on Section 2 of this document and/or talk to
    your doctor or qualified exercise professional before continuing with any physical activity
    programme.

  • Client Awareness Statement

  • I am aware of the risks in observing or participating in the activities being offered and I understand that all sports or fitness that I will execute and participate in are entirely my choice and resposibility. I assume complete responsibility and liability for all activities I participate in and for any injuries that may occur as a result of these activities, even if injuries occur in a manner that is not foreseeable at the time I sign this agreement.

    I realize that I am participating fully aware of any and all risks involved, and that I am solely responsible for any loss or damage I may sustain; including personal injuries to me, damage to my property or any other occuring outcomes, resulting from my participaton.

     

  • Clear
  • PAR-Q+ (Physical Activity Readiness Questionnaire)

    SECTION 3 - DECLARATION
  • If you answered NO to all of the follow-up questions about your medical condition, you are ready to become more physically active:
    › It is advised that you consult a qualified exercise professional to help
    you develop a safe and effective physical activity plan to meet your health needs.
    › You are encouraged to start slowly and build up gradually – 20-60 min. of low- to moderate-intensity
    exercise, 3-5 days per week including aerobic and muscle strengthening exercises.
    › As you progress, you should aim to accumulate 150 minutes or more of moderate-intensity physical
    activity per week.
    › If you are over the age of 45 yrs. and NOT accustomed to regular vigorous physical activity, please
    consult a qualified exercise professional before engaging in maximal effort exercise.


    If you answered YES to one or more of the follow-up questions about your medical condition:
    › You should seek further information from a health care professional before becoming more
    physically active or engaging in a fitness appraisal and/or visit a or qualified exercise professional
    for further information.
    Delay becoming more active if:
    › You are not feeling well because of a temporary illness such as a cold or fever – wait until you feel better
    › You are pregnant - talk to your health care practitioner, your physician, a qualified exercise profesional,
    and/or complete the PARmed-X for Pregnancy before becoming more physically active OR
    › Your health changes - please talk to your doctor or qualified exercise professional before
    continuing with any physical activity programme.

  • Clear
  •  -  - Pick a Date  :
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free! Create your own Jotform