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Fitness Par-Q Form

Personal Details

If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below.  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 start.  If you are over 69 years of age, and you are not use to being very active, check with your doctor.

 Please read the questions carefully and answer each one honestly. 

Has your doctor ever said that you have a heart condition and 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?
Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your activity?
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

If you answered yes to one or more of the above questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal.  Tell your doctor about the PAR-Q and which questions you answered YES

•  You may be able to do any activity you want — as long as you start slowly and build up gradually.  Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

•  Find out which community programs are safe and helpful for you.

If you answered no to one or more of the above questions:

If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:

  • Start becoming much more physically active – begin slowly and build up gradually.  This is the safest and easiest way to go.

  • If your health changes so that you answer YES to any of the above questions, consult a doctor before continuing with your physical activity plan.

Disclaimer: Kelly's health and fitness academy assumes no liability for persons who undertake physical activity, if you are in any doubt after completing this form, consult your doctor prior to starting your physical activity plan.  View full disclaimer

Data Protection 2018: Kelly's Health & Fitness Academy endorses the Data Protection Act 2018 and thanks you for supplying your information. Your information will not be shared.


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