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Physical Activity Readiness Questionnaire 2020

The Physical Activity Readiness Questionnaire (PAR-Q) is designed to assess an individual's readiness for physical activity and identify any health concerns that may require medical advice. It includes seven health-related questions that help determine if further consultation with a doctor or exercise professional is necessary. Participants must sign a declaration acknowledging their understanding of the questionnaire and its validity for five months, with confidentiality maintained by the fitness center.

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Jasmine Cabo Berja
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226 views2 pages

Physical Activity Readiness Questionnaire 2020

The Physical Activity Readiness Questionnaire (PAR-Q) is designed to assess an individual's readiness for physical activity and identify any health concerns that may require medical advice. It includes seven health-related questions that help determine if further consultation with a doctor or exercise professional is necessary. Participants must sign a declaration acknowledging their understanding of the questionnaire and its validity for five months, with confidentiality maintained by the fitness center.

Uploaded by

Jasmine Cabo Berja
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

I.

Physical Activity Readiness Questionnaire 2020 (PAR-Q)

This is a tool used to test an individual’s capability to be engaged in a particular


Physical Activity; it will serve as a reference to determine if an individual is fit enough to
do the activity, aforementioned. This can also help in knowing one’s physical strengths,
and weaknesses; as well as in seeking medical assistance, if necessary.
The Physical Activity Readiness Questionnaire for Everyone
The health benefits of regular physical activity are clear; more people should
engage in physical activity everyday of the week . Participating physical activity is
very safe for MOST people. This questionnaire will tell you whether it is necessary
for you to seek further advice from your doctor or a qualified exercise professional
before becoming more physically active.

GENERAL HEALTH QUESTIONS


Please read the 7 questions below carefully and answer each one
YES NO
honestly: check YES or NO.
1. Has your doctor ever said that you have a heart condition or
high blood pressure?
2. Do you feel pain in your chest at rest, during your daily
activities of living, or when you do physical activity?
3. Do you lose balance because of dizziness or have you lost
consciousness in the last 12 months? Please answer NO if your
dizziness was associated with over-breathing (including during
vigorous exercise)
4. Have you ever been diagnosed with another chronic medical
condition (other than heart disease or high blood pressure)
Please list condition(s) here:_________
5. Are you currently taking prescribed medications for chronic
medical condition? Please list conditions and medications here:
__________________
6. Do you currently have (or have had within the past 12 months)
a bone, joint, or soft tissue (muscle, ligament, or tendon)
problem that could be made worse by becoming physically
active? Please answer NO if you had a problem in the past, but
it does not limit your current ability to be physically active.
Please List conditions here:___________
7. Has your doctor ever said that you should only do medically
supervised physically activity?
II. PARTICIPANT DECLARATION

 All persons who have completed the PAR-Q+ please read and sign the
declaration below.

I, the undersigned, have read, understood to my full satisfaction and completed this
questionnaire. I acknowledge that this physical activity clearance is valid for a 5 months from
the date it is completed and becomes invalid if my condition changes. I also acknowledge that
the community/fitness center may retain a copy of this form for records. In these instances, it
will maintain the confidentially of the same, complying with applicable law.

NAME: _______________________________________ DATE_______________________


SIGNATURE: _________________________________ WITNESS: ___________________

SIGNATURE OF PARENT/ GUARDIAN/CARE PROVIDER: ___________________________

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