New clients · Form 2 of 2

PAR-Q readiness questionnaire

The Physical Activity Readiness Questionnaire is designed to help you help yourself. Regular exercise is safe for most people, but a few should check with a doctor first.

Seven quick questions. If you answer yes to any of them, talk with your doctor before you start becoming much more physically active.

Your name

Name*

Seven questions

Answer each one honestly. If you answer yes to any question, talk with your doctor before you start becoming much more physically active.

1. Has your doctor ever said you have heart trouble?*

YesNo

2. Do you frequently have pains in your heart and chest?*

YesNo

3. Do you often feel faint or have spells of severe dizziness?*

YesNo

4. Has a doctor ever said your blood pressure is too high?*

YesNo

5. Has your doctor ever told you that you have a bone or joint problem, such as arthritis, that has been aggravated by exercise or might be made worse with exercise?*

YesNo

6. Is there a good physical reason, not mentioned here, why you should not follow an activity program even if you wanted to?*

YesNo

7. Are you over the age of 65 and not accustomed to vigorous exercise?*

YesNo

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