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Physical Activity Readiness Questionnaire (PAR-Q).

If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you become more physically active. If you are over 69 and are not used to being very active, check with your doctor first. Please read each question carefully and tick the box if you answer YES.

1. Has your doctor ever told you that you have a heart condition?

2. Has your doctor said that you should only do physical activity recommended by a doctor?

3. Do you ever feel pain in your chest when you do physical activity?

4. In the past month, have you had a chest pain when you were not doing physical activity?

5. Do you lose balance because of dizziness or do you ever lose consciousness?

6. Do you have a bone or joint problem (e.g. back, hip or knee) that could be made worse by a change in your physical activity?

7. Are you currently being prescribed medication to control blood pressure or a heart condition?

8. Are you or could you be pregnant, or have you given birth within the last 3 months?

9. Do you know of any other reason why you should not take part in, or have to limit any physical activity? (e.g. recent surgery, illness or disease such as diabetes)

If you have answered YES to one or more of the questions above, your should consult with your doctor to clarify that it is safe for you to become more physically active. If you answered NO to all the questions above, it is reasonably safe for you participate in physical activity, gradually building up from your current ability level. You should delay starting an exercise programme if you are suffering from a temporary illness such as a cold or fever - wait until you feel better. *

I have read, understood and accurately completed this questionnaire. I confirm that I wish to voluntarily participate in a programme of physical activity, and am aware that participation involves a risk of injury. If my health changes so that I would answer YES to any of the questions on the PAR-Q, or if I become injured, I will inform Dylan Worthington Personal Training Ltd. by e-mail or text message before my next training session.