Trained By Gee PAR-Q (Health Questionnaire)

  • Pre-Activity Readiness Questionnaire

    (PAR-Q)

  • The information contained within this form will help your trainer decide whether you are safe to exercise 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 Trained By Gee Coaches Only.

  • 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?*
  • Do you suffer from high cholesterol?*
  • Have you had surgery in the past 5 years? *
  • Is there a history of coronary disease in your immediate family?*
  • Do you have any chronic illnesses or physical limitations such as asthma or diabetes and whether it affects your ability to exercise?*
  • Do you have any injuries, bone/joint or orthopedic problems (such as back, shoulder, knee etc) that affect your ability to exercise?*
  • 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?*

  • Talk to your Doctor either in person or by phone before you start becoming more physically active and/or taking a fitness appraisal. Tell your Doctor what questions you answered yes to on this form.

    You may still be able to do any activity you want as long as you start slowly and build up gradually or it may be that you need to restrict your activities to those which are safe for you. 

    If you have answered YES to any of the questions above, a reasoned judgement will need to be made as to whether consent is required from your Doctor prior to commencing any physical activity with Georgia or Trainers.

    If Trained By Gee decides that you need consent from your Doctor to commence any program of activity with us, you may wish to continue training, however we will require written consent from yourself to do this and a signed waiver form.

  • Lifestyle Questions

  • Describe your job: *
  • Do you smoke?*
  • Do you drink alcohol? *
  • Do you suffer/have suffered from eating disorders?*

  • Emergency Contact

  • Format: 00000000000.

  • By submitting this form, you agree to Trained By Gee capturing photos and/or video during sessions, classes, or events. This content may be used for marketing, promotional materials, and social media.

  • Should be Empty: