Physical Activity Readiness Questionnaire (PAR-Q)

Physical Activity Readiness Questionnaire (PAR-Q)

Please complete this form before starting any physical activity programme.
Name
Age
Date of Birth

DayMonthYear
Date
Address
Town
Postcode
Your Mobile Number
Format: 07000 000000.
Email
example@example.com
Emergency Contact
Their Mobile Number
Format: 07000 000000.
Medical Questionnaire
1. Do you have any existing medical conditions? (heart disease, diabetes, asthma, etc. If yes, please provide details).
Medical Conditions Detail
2. Are you currently taking any medications? If yes, please list them.
Medications Detail
3. Do you have any allergies (e.g., food, medication, environmental)? If yes, please specify
Allergies Detail
4. Have you ever had surgery or been hospitalised in the past? If yes, please provide details.
Hospitalisation or Surgery Detail
5. Do you have any chronic pain or musculoskeletal injuries? If yes, please specify the location and nature of the pain/injury.
Chronic pain or musculoskeletal injuries Detail
6. Do you suffer from any of the following? (Check all that apply & If yes to any, please provide details.)
Further Details
Fitness History
1. Are you currently following an exercise program?
If yes, what type of exercises are you doing, and how often?
2. Have you worked with a personal trainer before?
If yes, what did you enjoy or not enjoy about the experience?
3. What are your main fitness goals? (e.g., weight loss, strength, endurance, injury recovery, etc.)
4. Are there any exercises or activities you currently avoid or would like to avoid due to pain or discomfort?
If yes, please list them.
1. How would you describe your general activity level
2. How many hours of sleep do you get on average per night
3. Do you follow any specific diet or nutrition plan? If yes, please describe it.
4. Are you currently pregnant or trying to conceive
5. Do you have any specific mobility flexibility or balance challenges
6. Are there any other health concerns conditions or limitations you believe we should be aware of before we begin training
Client Declaration
I confirm that I have been shown how to use the gym equipment safely and am happy to train unsupervised. I have read, understood, and accurately completed this questionnaire. I understand that I am voluntarily engaging in exercise and accept full responsibility for any risks, including the risk of injury.

If you are currently experiencing, have previously suffered from, or in future develop any health condition—including pregnancy—or are taking medication, it is your obligation to obtain written medical clearance from your doctor confirming that it is safe for you to exercise.

You must inform Danny Livings Personal Training immediately of any changes to your health or medical condition and provide the relevant medical release documentation.

By signing below, I confirm that all information provided is accurate and complete to the best of my knowledge, and I accept full responsibility for my participation in training sessions with Danny Livings Personal Training.
1. Do you consent to the collection of this information for the purpose of creating a personalised fitness plan?
2. Do you understand the risks involved with physical activity, including but not limited to injury or adverse reactions, and consent to participate in a fitness program?
3. Have you consulted a healthcare professional regarding your readiness to engage in physical exercise
4. Are you aware that it is important to inform your trainer of any changes in your health or fitness status during the course of your training?
5. I agree to the terms & Conditions below (these will also be emailed to you on completion).
Signature
Date

MonthDayYear
Date
Should be Empty:

Physical Activity Readiness Questionnaire (PAR-Q)

Medical Questionnaire

Fitness History

Client Declaration