ParQ_Screening

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If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you significantly
change you physical activity patterns.

If you are over 69 years of age and are not used to being very active, check with your doctor.

Please read the following questions carefully and check (X) next to the appropriate answers. Answer all questions honestly and to the best of your ability

YES/ NO **

Rows	No	Yes
Has your doctor ever said that you have a heart condition (had a stroke, heart attack, or heart surgery) and/ or that you should only do physical activity recommended by a doctor?
Has your doctor ever said that you have a heart condition (had a stroke, heart attack, or heart surgery) and/ or that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Have you ever been told by a doctor that you have bone, joint, or muscle problems that could be made worse by physical activity?
Do you have a diagnosed illness that could be made worse by physical activity?
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity? If YES, Please comment below...
Mental Health Issues?
Do you know any reason you should not exercise or do physical activity?

Reasons you are unable to do physical exercise:

If you answered YES to one or more questions:
You should consult with your doctor to clarify that it is safe for you to become physically active at this current time and in your current state of health.

If you answered NO to ALL of the questions:

It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level.

A fitness appraisal can help determine your ability levels

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 a risk of injury.

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Date

Having answered YES to one of the questions above, I have sought medical advice and my GP has agreed that I may exercise

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Age:

Weight:

Height:

Note: This PAR Q becomes invalid should your condition change.

Par Q Physical Activity Readiness Questionnaire