The Physical Activity Readiness Questionnaire PAR Q Form is a personal fitness evaluation of an individual that they normally must fill in so that they are able to participate in physical activity. This is a 1-page form to see if you should check with your doctor before becoming much more physically active.
Name: ………………………………………………….. Date: ……………………………………………….
Telephone: ………………………………………………………
Date of Birth: ………….. Age: …………… Height: …………… Weight (Lbs): …………………
In case of Emergency contact: ………………………………. Relationship: ………………
Address: ……………………………………………………
Do you take an medication that we should be aware of?: YES NO
If YES, Please state: ……………………………………………………………………………………………………………………
Do you smoke? YES NO
Are you pregnant? YES NO
YES NO 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you were not doing physical activity?
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
7. Do you know of any other reason why you should not do physical activity?
Report
Explain the health and safety considerations required for exercise and training
Exercise can offer many health benefits for people who want to reduce the risk of developing heart disease, stroke, high blood pressure, some cancers, type 2 diabetes and osteoporosis. It also helps with weight loss and stress relief.
There are only a few reasons why physical activity may be harmful. A common wrong belief is that physical activity may be bad for the heart. However this is far from the truth, physical activity is good for most people with heart disease provided they follow guidelines given by exercise specialists or health professionals. In general, if you gradually build up to do regular moderate intensity physical activity, the potential benefits to your health will greatly outweigh the small risks involved.
However, sometimes problems can occur with physical activity:
Injury is possible. Sprains, and sometimes more serious injuries, are a risk with some types of physical activity. You can cut down your risk of injury by warming up before any activity, and by wearing the correct footwear.
Endurance sports such as marathon running can sometimes cause stress fractures in bones. Prolonged endurance exercising can mean that some women stop having their monthly periods.
In rare cases, sudden death can occur in people who are doing some physical activity. However, most of the time, there is usually an underlying heart problem (which may not have been previously diagnosed) and it is the excess stress that is placed on the person's body during exercise that causes the sudden death. In general, regular exercise protects the heart and thickens the walls overtime.
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