Physical Activity Readiness Questionnaire
The physical activity readiness questionnaire (PAR-Q) can help you decide if you are ready to exercise safely, or if you might need a trip to your physician to make sure you don't push beyond your own limit.
Email *
Name *
Date of birth *
MM
/
DD
/
YYYY
Current Physical Activity *
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *
In the past month, have you had chest pain when you were not doing physical activity? *
Do you feel pain in your chest when you do physical activity? *
Do you lose your balance because of dizziness or do you ever lose consciousness? *
Do you have a bone or joint problem (e.g. back, knee or hip) that could be made worse by a change in your physical activity? *
Is your doctor currently prescribing medication for your blood pressure or a heart condition? *
Do you have Type 2 Diabetes? *
Do you have an injury? *
Do you know of any other reason why you should not do physical activity? *
If you answered 'yes' to any of the above please provide some details below
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.