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
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.