Physical Activity Readiness Questionnaire (PAR-Q)

Physical Activity Readiness Questionnaire (PAR-Q)
Do you have a heart condition or cardiovascular disorder?
Did a doctor advise you to limit physical activity and only perform the recommended activities by a professional?
Is there any chest pain when you're doing any physical activity?
In the past month, did you experience any pain in the chest area when you're not doing anything?
Do you usually lose your balance due to being dizzy or even lose your consciousness?
Are you experiencing bone or joint problems that worsen if you change your physical activity?
Are you currently taking medications for your blood pressure or heart condition?
Is there any reason why you should not do physical activities?
If your answer is "NO" to all of the questions above, then you are safe to participate in physical activities.

If you answer "YES" to one or more questions, then you need to consult your doctor to clarify if you're capable of doing physical activities in your current state.
Personal Information
Name

First NameLast Name
Gender
Age
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Occupation
Emergency Contact Person

First NameLast Name
Emergency Contact Person No.
Please enter a valid phone number.Format: (000) 000-0000.
Height
Weight
What are your fitness goals? Please be as specific as possible
Signature
Have you had any injuries in the past? Please specify below
How active are you currently?
How motivated are you to reach your fitness/health goals?
Which service would you like to sign up for?
Should be Empty:

Physical Activity Readiness Questionnaire (PAR-Q)

Personal Information