Physical Activity Readiness Questionnaire (PAR Q) for Joanne Powley Pilates
Email address *
Name *
Address *
Mobile telephone *
Date of Birth *
What is your reason for starting Pilates?
Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? *
Do you feel pain in your chest when you do physical activity? *
In the past month, have you had a chest pain when you were not doing physical activity? *
Do you lose balance because of dizziness or do you ever lose consciousness? *
Do you have a bone or joint problem ( for example 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 heart condition? *
Do you know of any other reason why you should not take part in physical activity? *
If YES, please comment:
I have read, understood and accurately completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury. *
Having answered YES to one of the questions above, I have sought medical advice and my GP has agreed that I may exercise.
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