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PAR Q Form

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0% found this document useful (0 votes)
4 views2 pages

PAR Q Form

Uploaded by

speedmangopota
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Physical Activity Readiness

PAR-Q & YOU


(revised 2002)
(A Questionnaire for People Aged 15 to 69)
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being
more active is very safe for most people. However, some people should check with their doctor before they start becoming much
more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in the box
below. 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 start. If
you are over 69 years of age, and you are not used to being very active, check with your doctor.
Common sense is your best guide when you answer these questions.
Please read the questions carefully and answer each one honestly: check YES or NO.
YES NO
1. Has your doctor ever said that you have a heart condition and that you should only do physical activity
recommended by a doctor?

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

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

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

5. 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?

6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

7. Do you know of any other reason why you should not do physical activity?
If YES to one or more questions
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have
you a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.
• You may be able to do any activity you want — as long
answered as you start slowly and build up gradually. Or, you may
need to restrict your activities to those which are safe for you. Talk with your doctor
about the kinds of activities you wish to participate in and follow his/her advice.
• Find out which community programs are safe and helpful for you.
DELAY BECOMING MUCH MORE ACTIVE:
NO to all questions • if you
because of
are not
a
feeling well
temporary
If you answered NO honestly to all PAR-Q questions, you can be reasonably
illness such as a cold or a fever
sure that you can:
– wait until you feel better; or
• start becoming much more physicallyactive –
• if you are or may be
begin slowly and build up gradually.
pregnant – talk to your
This is the safest and easiest way to go.
PLEASE NOTE: doctor
If your health changes
before youso thatstart
you then
becoming
• take part in a fitness appraisal – this answer YESactive.
more to any of the above questions, tell your fitness
is an excellent way to determine or health professional.
your basic fitness so that you can plan the best way Ask whether you should change your physical activity plan.
for you to live actively. It is also highly recommended that you have your
blood pressure evaluated. If your reading is over 144/94, talk with your
doctor before you start becoming much more physically active.

Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical
activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

No changes permitted. You are encouraged to photocopy the PAR-Q but only if you use the entire form.

NOTE: If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may be used for legal or
administrative purposes.

"I have read, understood and completed this questionnaire. Any questions I had were answered to my full
satisfaction."
NAME ________________________________________________________________________

SIGNATURE _______________________________________________________________________________ DATE ______________________________________________________

SIGNATURE OF PARENT _______________________________________________________________________ WITNESS ___________________________________________________


or GUARDIAN (for participants under the age of majority)

Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes
invalid if your condition changes so that you would answer YES to any of the seven questions.

© Canadian Society for Exercise Physiology www.csep.ca/forms

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