PAR Q

✅ PAR-Q (Physical Activity Readiness Questionnaire)

House of GlamRock – Standard PAR-Q Form

Please answer YES or NO to the following:

1. Has your doctor ever said you have a heart condition and 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 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 that could be made worse by a change in physical activity?

6. Is your doctor currently prescribing medication for your blood pressure or a heart condition?

7. Do you know of any other reason you should not do physical activity?

If you answered YES to one or more questions: Consult with your physician before increasing physical activity or undergoing a fitness assessment.

If you answered NO to all questions: You may begin fitness activities, starting slowly and increasing intensity gradually.

Signature: ______________________  Date: __________ Trainer Initials: ________________