Physical Activity Readiness Questionnaire (PAR-Q)
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If you are between the ages of 18 and 69, the PAR-Q will tell you if you should check with your doctor before you significantly change your physical activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor. Common sense is your best guide when answering these questions. Please read carefully and answer each one honestly.
Medical Questions - Please tick either YES or NO
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
Do you feel pain in your chest when you perform physical activity?
In the past month, have you had chest pain when you were not performing any physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity? (i.e. back, knee, hip, neck)
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition? (i.e. water pills)
Are you pregnant now or have you given birth within the last 6 months?
Do you know of any other reason why you should not engage in physical activity? If yes, please explain)
Are you currently on any regular medications?
Has a GP ever told you that exercise would be dangerous for you to engage with?
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Informed Use of the PAR-Q
Dawn Ingram Yoga and its agents assume no liability for persons who undertake physical activity, and if in doubt, after completing this questionnaire, consult your doctor prior to commencing physical activity.
"I have read, understood and completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable level of exercise and my participation involves a risk of injury."
"I hereby release Dawn Ingram and Dawn Ingram Yoga from any liability with respect to any damage or injury (including death) that I may suffer whilst exercising."
Informed Use of the PAR-Q Dawn Ingram Yoga and its agents assume no liability for persons who undertake physical activity, and if in doubt, after completing this questionnaire, consult your doctor prior to commencing physical activity. "I have read, understand and 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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