Physical Activity Readiness Questionnaire (PAR-Q)

If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you significantly change your physical activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor. Common sense is your best guide when answering these questions.

If you have a bone, joint or any other problem that causes you pain or limitations that must be addressed when developing an exercise programme, please provide details in the relevant section. (i.e. diabetes, osteoporosis, high blood pressure, high cholesterol, arthritis, anorexia, bulimia, anaemia, epilepsy, respiratory aliments, back problems, exercise induced asthma, low blood sugar levels- hypoglycemia etc.)

Please read carefully and answer each one honestly: Type Y/N (YES or NO)

YES to one or more questions: You should consult with your doctor to clarify that it is safe for you to become physically active at the current time and in your current state of health.

NO to all questions: It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level.

NOTE: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the questions.

Completion and submission of this form acts as confirmation that you are voluntarily engaging in an acceptable level of exercise and that your participation involves a risk of injury.

Email*

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? Y/N*

Do you feel pain in your chest when you do physical activity? OR in the last month when not doing in physical activity? Y/N*

Are you pregnant or have given birth in the last 6 months? Y/N*

Do you lose balance or dizziness or do you ever lose consciousness? Y/N*

Do you have a bone, joint or any other problem that causes you pain or limitations that must be addressed when developing an exercise programme? Y/N *

Is your doctor currently prescribing medication for your blood pressure or heart condition? Y/N*

If you have answered YES to one of the questions,please confirm that you have sought medical advice and your GP has agreed that you may exercise. Y/N

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