Thanet Fitness Parq

  • Pre-Activity Readiness Questionnaire (PAR-Q)

  • The information contained within this form will help us agree whether you are safe to train or not. If there is any doubt regarding your fitness to train you should consult your GP.

    Note: this information will be kept confidentially and only accessed by Natalie Lowe

  • Your Details

  • Date of Birth*
     - -
  • Format: 00000000000.

  • Health Questions

  • Has your Doctor ever said you have a heart condition?*
  • Do you have pains in your chest whilst performing physical activity?*
  • Have you had chest pain while not doing physical activity?*
  • Do you lose your balance due to dizziness or ever lose consciousness?*
  • Do you suffer from high or low blood pressure?*
  • Have you had surgery recently?*
  • Is there a history of coronary disease in your immediate family?*
  • Do you have any chronic illnesses or physical limitations?*
  • Do you have any injuries, bone/joint or orthopedic problems (such as back, shoulder, knee etc) that could be made worse by physical activity?*
  • Do you take any medication (prescription or non-prescription) that affects your ability to exercise?*
  • Do you know of any other factor which may affect your ability to participate in physical activity?*

  • Emergency Contact

  • Format: 00000000000.

  • I confirm that I have read, understood, and accurately completed this questionnaire. I acknowledge that I am voluntarily participating in an exercise program provided by my trainer, Natalie Lowe, and understand that participation may involve a risk of injury. I have informed Natalie Lowe of any pre-existing injuries or underlying conditions and will continue to do so if this information changes at any time.

  • Date
     - -

  • PROMOTIONAL:
    By signing this document I hereby consent that natalie lowe may occasionally take and or use pictures of progress or participation for promotional business purposes

  • Date
     - -
  • Should be Empty: