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par-q

YOLO Fitness – PAR-Q

(Physical Activity Readiness Questionnaire)

Before starting any exercise program, it’s important to know if you are ready to safely take part in increased physical activity. Please answer the following questions honestly.

Birthday
Day
Month
Year

Health Screening Questions

Please check "Yes" or "No" for each question.

Has your doctor ever said you have a heart condition or that you should only do physical activity recommended by a doctor?
Yes
No
Do you feel pain in your chest when you do physical activity?
Yes
No
In the past month, have you had chest pain when you were not doing physical activity?
Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
Yes
No
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?
Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
Yes
No
Is your doctor currently prescribing medication for your blood pressure or a heart condition?
Yes
No
Do you know of any other reason why you should not do physical activity?
Yes
No

If you answered YES to any of the questions please provide more information below.

Based on your answers, you may need to check in with your GP before starting a new exercise routine. I’ll review your form and let you know if medical clearance is needed before we get going.

Declaration & Signature

I confirm that the above information is correct to the best of my knowledge. I understand it is my responsibility to inform YOLO Fitness of any changes to my health.

Date
Day
Month
Year

Contact

Got questions? Or looking for something a little different? Drop me a message — I’d love to help you find what works for you!

Thanks for submitting!

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