PARQ:

Have you or any of your immediate family ever have :
1:Elevated blood pressure   YES    NO   
2:Elevated cholesterol levels   YES   NO   
3:Chest pain (with or without shortness of breath)   YES   NO   
4:Stroke/Heart attack   YES   NO   
5:Angina   YES   NO   

any context you would like us to know :   Type a label   

Are you currently taking any medication ? (if yes, which )  
 YES   NO   
Type a label   

Have you been under treatment now or in the last six months ? (if yes , which )
YES   NO   

Have you had surgery in the last 24 months ? (if yes, for what exactly )
YES   NO   

Have you ever had a hernia ?
YES   NO   

Do you have diabetes ?
YES   NO   

Do you have arthritis ?
YES   NO   

Do you have (or in the last 6 months )any joint/ muscle pain? (if yes , which)
YES   NO   
Type a label   

Has any medical practitioner ever warned you against exercise ? (if yes, why)
YES   NO   
Type a label   

Are you pregnant (now or in the last 3 months)
    YES   NO   

Are you a sedentary male over 35 or female over 45 ?
YES   NO   

NB:
If you have marked "YES" (or you don't know) to any question above , please take the "letter your Medical Practitioner" included overleaf to your Doctor and obtain clearance for assessment and guidance for subsequent activity. Your Doctor's clearance is needed before your assessment ... if you cannot see your Doctor before scheduled assessment ,please phone +27 625190131 or contact 3dfitness.events@gmail.com and re-schedule your assessment to after your Doctors appointment.

Were you guided toward exercise by the/a medical professional  ?
 YES    NO   

Are you taking any oral contraceptive ?
YES   NO   

Do you have Hypoglycemia ?
YES   NO   

Do you ever feel faint or suffer from dizzy spells ?
YES   NO   

Have you ever suffered from respiratory problems(asthma etc)?
YES   NO   

Do you smoke (cigarettes , vapes etc )?
YES    NO   

If you have answered "YES" to any of the above questions, please follow the directions in the "NB" section above .

Is there anything that could be deemed relevant to your participation in an activity program that you have not told us yet ? if so please fill in below .
Type a label   

Please select "P" for any activity in which you have participated in the last twelve months, and then "F" for any activity you like to participate in the future, "B" for both .

1:RUNING      PFB      
2:CYCLING      PF   B   
3:TRITHLON         P F   B    
4:AEROBIC CLASSES PFB      
5:WALKING      P F B     
6:ROCK CLIMBING    PFB      
7:RUGBY     PF B   
8:BALLET PF B     
9:MARTIAL ARTS   PF B      
10:SWIMMING    PFB   
11:CANOEING PF B      
12:SQUASH  P F B   
13:TENNIS  P B      
14:BASKETBALL   PF B      
15:HOCKEY    PFB            
16:NETBALL   PFB      
17:CRICKET  PFB      
18:SKIING         P     F B   
19: SAILING   PFB     
20:OTHER (please list)   PF B      
            

Using the scale above ,please give a personal value to each of the following