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The Core Gym - Physical Activity Readiness Questionnaire (PAR-Q)

Talk with your doctor by phone or in person if you answered YES to one or more of the questions
BEFORE you start becoming much more physically active. Tell the doctor about the PAR-Q and
which questions you have answered YES to.
- You may be able to do any activity you want – as long as you start slowly and build up
gradually. 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.
If you answered NO to all the questions you can be reasonably sure you can take part in physical
activity. If you are still unsure please contact your doctor.
Delay becoming much more active if you are:
- Not feeling well because of a temporary illness such as a cold or fever.
- If you have a specific undiagnosed injury.
- If you are or may be pregnant – talk to your doctor about becoming more active.
PLEASE NOTE: IF YOUR HEALTH CHANGES SO THAT YOU WOULD ANSWER YES TO ANY OF THE
ABOVE QUESTIONS, PLEASE TELL THE FITNESS OR HEALTH PROFESSIONAL IMMEDIATELY.

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1. Has you doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes

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

Yes

3. In the past month, have you ever had chest pain when you weren’t doing physical activity?

Yes

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

Yes

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?

Yes

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

Yes

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

Yes

I have read, understood and completed this questionnaire. All questions were answered to my full satisfaction and I can confirm that I am able to take part in intense physical activity. If I have answered yes to any of the above questions and decided NOT to seek medical advice before taking part in The Core Gym exercise sessions, I understand that I am doing so at my own risk and not at the liability of the The Core Gym and it's coaches.

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