PAR-Q Online Personal Training
Email address *
Physical Activity Readiness Questionnaire (PAR-Q)
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor? *
Do you feel pain in your chest when you perform physical activity? *
In the past month, have you had chest pain when you were not performing any physical activity? *
Do you lose your balance because of dizziness or do you ever lose consciousness? *
Do you have a bone or joint problem that could be made worse by a change in your physical activity? If yes, clarify: *
Your answer
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition? *
Do you know of any other reason why you should not engage in physical activity? *
Your answer
Have you had any surgeries? If yes, please list: *
Your answer
Have you had any injuries? If yes, please list: *
Your answer
Do you currently have or have had in the past any of these conditions *
If selected any of the above, please clarify: *
Your answer
Are you currently taking any medication? (If YES, please explain.) *
Your answer
Anything else I need to know? *
Your answer
Never submit passwords through Google Forms.
This form was created inside of Fitness by Jessi. Report Abuse