Physical Activity Readiness Questionnaire

PARQ Questionnaire
Please complete the necessary details below:
Please read the questions carefully and answer honestly QUESTIONS RELATED TO YOUR MEDICAL HEALTH
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Is your doctor currently prescribing you drugs (for example water pills) for blood pressure or a heart problem?
Do you ever feel pain in your chest when you do physical activities?
In the past month have you had chest pain when you are not doing physical activity?
Do you ever feel faint or have spells of dizziness?
Do you suffer from shortness of breath at any time?
If you suffer from asthma, including exercise induced asthma, is there any reason why you should not participate in the activity?
Do you have a joint problem (including neck, back or hip problems) that could be made worse by exercise, including jumping and landing?
Are you aged 60yrs or older?
Are you pregnant or have you given birth in the last 6 months?
Are you currently taking any medication of which the instructor should be made aware?
Is there any other reason why you should not participate in physical activity?
If you have completed this PAR-Q in advance of the scheduled activity and your health status changes prior to the start of the activity, it is your responsibility to inform the instructor
Your ability to undergo the activity will be monitored during the warm up which will also provide a functional assessment of your ability to proceed.
Are you currently taking prescribed medication?
DISCLAIMER – Innovations Fitness recognises that physical activities which they offer may, in some circumstances create a risk of personal injury. Innovations Fitness goes to reasonable lengths to limit these risks as far as possible. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement. I have read, understood and completed all questions within this questionnaire to my full satisfaction.
Topsy Turner

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