The Physical Activity Readiness Questionnaire for Everyone
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The health benefits of regular physical activity are clear; more people should engage in physical activity every day of the week. Participating in physical activity is very safe for MOST people. This questionnaire will tell you whether it is necessary for you to seek further advice from your doctor OR a qualified exercise professional before becoming more physically active.
If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian, or care provider may complete this form on your behalf. Common sense is your best guide when you answer these questions. Please note you should delay becoming much more active if you have a temporary illness (such as a cold or fever). It is best to wait until you feel better. You may also download the print versions of the PAR-Q+ at www.eparmedx.com.
Please read the following seven (7) questions carefully and answer each one honestly: check YES or NO.
Since you answered YES to one or more of the questions above we ask that you complete a short series of questions to gain further information prior to providing further recommendations. Please select NO to all questions that do not apply to you.
Follow-up Q10: The following questions relate to other medical conditions not discussed above and whether you currently have two or more medical conditions?
Thank you for completing the follow-up questions regarding your medical condition(s)!
PLEASE READ, SIGN, AND PRINT OFF (as required by your trustee)
Your answers to this survey indicate that you should seek further information before becoming more physically active or engaging in a fitness appraisal.
It is recommended that you visit a qualified exercise professional (with advanced university training) or your family physician for further information. This does not mean that you cannot perform any physical activities. We recommend that you only engage in low-intensity physical activity until you have received clearance from your physician and/or have met with a qualified exercise professional. Once you receive clearance for unrestricted physical activity, it may be advisable to exercise under the direct supervision of a qualified exercise professional. This will assist in optimizing the health benefits of physical activity while minimizing the risk.
PARTICIPANT DECLARATION
All persons who have completed the PAR-Q+, please read and sign the declaration below.
If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian, or care provider must also sign this form.
I, the undersigned, have read, understood to my full satisfaction, and completed this questionnaire. I also acknowledge that the community/fitness center may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
Thank you for completing the first seven questions of the PAR-Q+ Survey!
PLEASE READ, SIGN, AND PRINT OFF (OR SAVE) THIS PAGE (as required by your trustee)
Your answers indicated that you are cleared to start becoming more physically active and/or to engage in a fitness appraisal. Follow the global recommendations on physical activity for your age (https://www.who.int/publications/i/item/9789240015128). You are encouraged to start slowly and build up gradually towards 20-60 minutes per session of low to moderate intensity aerobic activities, 3-5 days per week. As you progress, you should aim to accumulate 150 minutes/week of moderate intensity physical activity per week. You should also engage in low to moderate intensity muscular strengthening activities on 2-4 days per week, and flexibility exercises on most days of the week.
You may take part in a health and fitness appraisal. If you are over the age of 45 years and NOT accustomed to regular vigorous to maximal effort exercise, consult a qualified exercise professional before engaging in this intensity of exercise. If you have any further questions, contact a qualified exercise professional.
Delay becoming much more active if:
I, the undersigned, have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
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