Physical Activity Readiness Questionnaire

Physical Activity Readiness Questionnaire (PARQ)

YOGA FITNESS FOR BEGINNERS (LADIES ONLY)
Full Name

First NameLast Name
Contact number / Email address
Next of kin in case of emergency

NameContact Number
Please read the following questions carefully and check (X) next to the appropriate answers. Answer all questions honestly and to the best of your ability.

YES/ NO

Rows	Yes	No
Has your doctor ever said that you have a heart condition (had a stroke, heart attack, or heart surgery) and/ or that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Have you ever been told by a doctor that you have bone, joint, or muscle problems that could be made worse by physical activity?
Do you have a diagnosed illness that could be made worse by physical activity?
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

Physical Activity Readiness Questionnaire (PARQ)