PARQ Health Questionnaire
Please read the questions carefully and answer each one honestly, ticking the appropriate box or adding
information if necessary. Your responses will of course be kept in the strictest confidence. This form must be
completed, returned to your Fitness Advisor and assessed prior to availing the induction services.
Client Name *
Your answer
Client Postcode *
Your answer
Client Phone *
Your answer
Client Email *
Your answer
Facebook Name (if different)
Your answer
How did you hear about us? *
Would you like to be added to our subscription list (Receive important class updates & exclusive offers!)
Gender *
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
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