• Physical Activity Readiness Questionnaire (Par-Q) 

    Physical Activity Readiness Questionnaire (Par-Q) 

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Does your occupation require extended periods of sitting?*
  • 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?*
  • Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?*
  • Do you know of any other reason why you should not engage in physical activity?*

  • If you have answered YES to one or more of the above questions, consult your GP before engaging in physical activity. Tell your physician which questions you answered YES to.

    After medical evaluation, seek advice from your GP on what type of activity is suitable for your current condition.

    If you answered NO honestly to ALL PAR-Q questions, you can be reasonably sure that you can start becoming much more physically active – begin slowly and build-up gradually. This is the safest and easiest way to go.

    It is also highly recommended you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.

  • Please inform your personal trainer if you are feeling unwell because of a temporary illness such as a cold/fever or if you are or may be pregnant – talk to your doctor before becoming more active.  
     
    If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change you physical activity plan. 
     
    PLEASE NOTE AND CONFIRM THAT THE BELOW POINTS ARE CONFIRMED AND ADHEARED TO BEFORE EACH SESSION (GROUP OR 1-2-1 REMOTE SESSIONS) 
     
    Participants have checked the area they are working in and have ensured there are no obstacles or hazards.


    Participants are fit and well to complete the class.


    Any equipment being used by participants is being used in line with manufacturers guidelines.

  • I certify that my answers to the questions above are true and complete to the best of my knowledge. I understand and agree that it is my responsibility to inform my Trainer of the conditions or changes in my health, now and on-going, which might affect my ability to exercise safely and with minimal risk of injury. I also sign to say that I have sought medical advice on any/all questions within this PAR-Q form that I have answered ‘YES’ to and have been cleared to partake in the upcoming advised exercise programme. 
     
    Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completes and becomes invalid if your condition changes so that you would answer YES to any of the PAR-Q question. 

  • Health & Fitness Goals

  • What are your fitness goals?
  • What are your TOP 3 priorities in your health and fitness right now? Rank in order of importance.
  • Do you exercise regularly?*
  • Which exercise equipment do you have access to?*
  • In general, which days and times are you available to train at the gym?
    Rows
  • In general, which days and times are you available to train at home?
    Rows
  • Should be Empty: