Professional Personal Training TBT Physical Activity Readiness Questionnaire (PAR-Q)

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National Academy of Sports Medicine PAR-Q

Email *

First and Last Name *

Phone Number *

Date of Birth *

Has Your Doctor Ever Said that you have a heart condition and that you should only perform physical activity recommended by a doctor? *

Yes

Address *

Do you feel pain in your chest when you perform physical activity? *

Yes

In the past month, have you had chest pain when you were not performing any physical activity? *

Yes

Do you lose your balance because of dizziness or do you ever lose consciousness? *

Yes

Do you have a bone or joint problem that could be made worse by a change in your physical activity? *

Yes

Is your doctor currently prescribing any medication for your blood pressure or heart condition? *

Yes

Do you know of ANY other reason why you should not engage in Physical activity? *

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