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Foundry Bedford Ltd - PARQ

Physical Readiness Questionnaire.

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Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?

Yes

Do you feel pain in your chest when training?

Yes

In the past month, have you had any chest pain when you were not performing any physical activity?

Yes

Do you loose balance because of dizziness or do you ever loose consciousness?

Yes

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Yes

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

Yes

Do you know of any other reason why you should not engage in physical activity?

Yes

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction. I accept and understand, that if my health changes so that I then answer YES to any of the above questions, I need to tell my fitness professional.