PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q) & YOU
b
a
s
c
c
ecoming much more physically active. If you are planning to become more physically active than you are now, start by
nswering 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
hould check with your doctor before you start. If you are over 69 years of age and you are not used to being
very active,
Regular physical activity is fun and healthy and increasingly more people are starting to become more active everyday.
Being more active is very safe for most people. However, some people should check with their doctor before they start
heck with your doctor. Common sense is your best guide when you answer these questions. Please read the questions
arefully and answer each one honestly.
CHECK YES OR 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?
YES
NO
2. Do you feel pain in your chest when you do physical activity?
NO
YES
NO
3. In the past month, have you had chest pain when you were not doing physical activity?
NO
YES
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
NO
YES
5. Do you have a bone or joint problem that could be made worse by a change in your physical
activity?
YES
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or
heart condition?
YES
NO
7. Do you know of any other reason why you should not do physical activity? YES NO
IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, PLEAS
E FOLLOW THE ADVICE IN
THE BOX BELOW
Talk to your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE
you have 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 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.
IF YOU ANSWERED NO TO ALL QUESTIONS, PLEASE READ THE INSTRUCTIONS IN THE 2 BOXES
BELOW
You can start becoming much more physically active--- begin slowly and build up gradually. This is the safest and
easiest way to go.
You can take part in a fitness appraisal--- this is an excellent way to determine your basic fitness so that you can
plan the best way for you to live actively.
DELAY BECOMING MORE ACTIVE IF:
1. You are not feeling well because of a temporary illness such as a cold or a fever--- wait until you feel better.
2. You are or may be pregnant--- talk to your doctor before you start becoming more active.
PLEASE NOTE: IF YOUR HEALTH CHANGES SO THAT YOU THEN ANSWER YES TO ANY OF THE ABOVE QUESTIONS, TELL YOUR FITNESS OR
HEALTH PROFESSIONAL. ASK WHETHER YOU SHOULD CHANGE YOUR PHYSICAL ACTIVITY PLAN. 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 QUESTIONAIRE, CONSULT YOUR DOCTOR PRIOR TO
PHYSICAL ACTIVITY.
I have read, understood and completed this questionnaire. Any questions I had were answered to my full
satisfaction.
Name Date
Signature Witness
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome