Par-Q & You: (A Questionnaire For People Aged 15 To 69)

PAR-Q & YOU
Physical Activity Readiness Questionnaire

- PAR-Q
(Revised in April 2019) (A Questionnaire for People Aged 15 to 69)
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very
safe for most people. However, some people should check with their doctor before they start becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering 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 should check with your doctor before you start. If you are over 69 years of age, and
you are not used to being very active, check with your doctor.
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one
honestly : Check YES or NO.
YES NO
  Has your doctor ever said that you have a heart condition and that you should only do physical activity
recommended by a doctor?
  Do you feel pain in your chest when you do physical activity?
  In the past month, have you had chest pain when you were not doing physical activity?
  Do you lose your balance because of dizziness or do you ever lose consciousness?
  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?
  Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
  Are you currently pregnant or have you had a baby in the last six months?
  Have you ever been diagnosed with another chronic medical condition (other than heart disease or high
blood pressure)? PLEASE LIST CONDITION(S) HERE:
  Are you currently taking prescribed medications for a chronic medical condition? PLEASE LIST
CONDITION(S) AND MEDICATIONS HERE:
  Do you know of any other reason why you should not do physical activity?
If
YES to one or more questions
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or
you 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,
answered 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.

NO to all questions DELAY BECOMING MUCH MORE ACTIVE:

if you are not feeling well because of a temporary illness such
If you answered NO honestly to all PAR-Q questions, you can be as a cold or a fever - wait until you feel better; or
reasonably sure that you can : 
 if you are or may be pregnant - talk to your doctor before you
start becoming more active.
 start becoming much more physically active - begin slowly
and build up gradually. This is the safest and easiest way
to go.
 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. It is also highly recommended
that you have your blood pressure evaluated. If your reading
is over 144/94, talk with your doctor before you start
becoming much more physically active.
No changes permitted. You are encouraged to photocopy the PAR-Q but only if you use the entire form.
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.
Source of the PAR-Q: The Canadian Society for Exercise Physiology
“I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.”
Signature: ________________________________ Student No. /Course Yr. & Sec.: __________________________
Name: ________________________________________________________ Date: __________________________
Signature of Parent or Guardian: ________________________________________ Witness: ___________________

(for participants under the age of majority)
Note: 1.The information provided on this form will only be used for the application for use of Leisure and Cultural Services Department’s Fitness
Rooms and enrolment of recreation and sports activities. Only persons authorised by this Department will have access to such information for
the aforesaid purposes. For correction of or access to personal data collected by means of this form, please contact staff of the enrollment
counter/district.
2.If you answer “yes” to one or more questions in the “PAR-Q & YOU”, your physical condition may not be suitable for taking part in the activity
concerned. For safety’s sake, you should consult a doctor in advance and produce a medical certificate upon enrolment or hire of fitness
equipment to prove that you are physically fit for taking part in the activity. If you fail to produce a medical certificate, you must submit the
completed Declaration upon enrolment or hire of fitness equipment.
3.If you fail to submit the “PAR-Q & YOU”, your application for enrolment of recreation and sports activities or use of Leisure and Cultural
Services Department’s Fitness Rooms will not be entertained. This physical activity clearance is valid for one year from the date it is
completed. Registered fitness room users have to re-submit a new questionnaire after the valid period expired.
This physical activity clearance becomes invalid if your condition changes so that you would answer YES to any of the seven questions.
(Revised in April 2019)

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PAR-Q & YOU

Physical Activity Readiness Questionnaire

NO to all questions DELAY BECOMING MUCH MORE ACTIVE:

Please note: If your health changes so that you then answer

Source of the PAR-Q: The Canadian Society for Exercise Physiology

Signature: ______ Student No. /Course Yr. & Sec.:

Name: ______________________________ Date:

Signature of Parent or Guardian: ______________________ Witness: _

(Revised in April 2019)

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