PAR-Q+

PAR-Q+

The Physical Activity Readiness Questionnaire for Everyone
The health benefits of regular physical activity are clear; more people should engage in physical activity every day of the week. Participating in physical activity is very 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.
General Health Questions

Please read the 7 questions below carefully and answer each one honestly: Check YES or NO.
1. Has your doctor ever said that you have a heart condition or high blood pressure?

YESNO
2. Do you feel pain in your chest at rest, during your daily activities of living or when you do physical activity?

YESNO
3. Do you lose balance because of dizziness or have you lost consciousness in the last 12 months? Please answer ‘no’ if your dizziness was associated with over-breathing (including during vigorous exercise)

YESNO
4. Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?

YESNO
If YES please list conditions here
5. Are you currently taking prescribed medications for a chronic medical condition?

YESNO
If YES Please list condition(s) and medications here
6. Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? Please answer no if you had a problem in the past, but it does not limit your current ability to be physically active.

YESNO
If YES please list conditions here
7. Has your doctor ever said that you should only do medically supervised physical activity?

YESNO
If you answered NO to all of the questions above, you are cleared for physical activity.

If you answered YES to one or more questions:

Talk with your doctor by phone or in person before you start becoming much more physically active or before you have a fitness appraisal. Tell your doctor about the PAR-Q and identify which questions you answered YES. You may be able to do any activity you want as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. I will need you to confirm that your doctor is happy for you to exercise before you start a fitness program with me.

Please note: if your health changes so that you then answer YES to any of the above questions, tell me. Ask whether you should change your physical activity plan.
If there is anything else you feel I should know, about your health, mobility or any injuries not covered in the questions above please note it here.
Please sign the PARTICIPANT DECLARATION.

I hereby state that I have read, understood and answered honestly the questions on the PAR-Q, and that any fitness tests and assessments have been explained to me.

I am willing to participate in physical activities that may include aerobic exercise, resistance exercise and flexibility exercises. I realise that in participating in these activities I may be at risk of injury and even the possibility of death.

I am voluntarily participating in an athletic or physical activity provided by AListon Davies with full knowledge, understanding and appreciation of the risks of injury inherent in any physical exercise, physical activity, or athletic activity and expressly assume all risks of injury and even death, which could occur by reason of my participation. and understand that I can withdraw at any time. I knowingly, voluntarily, and expressly waive any claim I may have against Get strong with Ali (Alison Davies) for injury or damages that I may sustain as a result of participating in the session.

I have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that BodE Well with Ali may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.

I also confirm that I agree to the Terms and Conditions and Privacy Policy
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PAR-Q+

General Health Questions