PAR-Q : Forge Ahead Injury Rehabilitation and Personal Training South West London

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Physical Activity Readiness Questionnaire (PAR-Q)

Before we start…

You should be aware that following questions are reasonable step towards enabling us both to plan & conduct physical activity in your life.

Usually physical activity does not pose any problem or hazard for healthy person. However PAR-Q form is aimed to identify those individuals that currently (or in the past) have particular health issues excluding some exercises or phisical activity whatsoever.

Has your doctor ever said that you have a bone or joint problem, such as arthritis, that has been aggravated by exercise or might be made worse with exercise? *

No
Yes

Do you have high blood pressure? *

No
Yes

Do you have low blood pressure? *

No
Yes

Do you have Diabetes Mellitus or any metabolic disease? *

No
Yes

Do you have high cholesterol level? *

No
Yes

Do you have any heart condition? *

No
Yes

Have you ever felt pain in chest when you do physical exercise? *

No
Yes

Are you on drugs or medications? *

No
Yes

Have you ever suffered from unusual shortness of breath at rest or with mild exertion? *

No
Yes

Is there any history of coronary disease in your family? *

No
Yes

Do you often feel faint, or have spells or severe dizzines or have you ever lost consciousness? *

No
Yes

Do you currently drink more than the average amount of alcohol per week (21 units-males, 14 units-f *

No
Yes

Do you currently smoke? *

No
Yes

Are you, or is there any possibility that you might be pregnant? *

No
Yes

This information will be stored and processed for the purpose of this enquiry and will not be shared, transferred or sold without consent.

I understand and agree

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