PLM Health & Fitness
Par-Q

Follow the simple steps to complete your Physical Activity Readiness.

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If you are between the ages of 18 and 69. The PAR-Q will tell you if you should check with your doctor before you significantly change your activity patterns. If you are over 69 years of age and are not used to being very active, check with your doctor. Common sense is your best guide when answering these questions, please read carefully and answer each one honestly. Tick YES or NO.

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

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

3. In the past month, have you had a chest pain when you were not doing physical activity?

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

5. Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in physical activity?

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

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7. Do you know of any other reason why you should not do physical activity? If yes, please comment:

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Complete Submission

Thank you for taking the time to complete the Par-Q form. Please enter your email below and tick the box accepting the declaration for submission.

I HAVE READ, UNDERSTOOD AND ACCURATELY COMPLETED THIS QUESTIONAIRE. I CAN CONFIRM THAT I AM VOLUNTARILY ENGAGING IN AN ACCEPTABLE LEVEL OF EXERCISE, AND MY PARTICIPATION INVOLVES A RISK OF INJURY.
Having answered YES to one of the above, I have sought medical advice and my GP has agreed that I may exercise.
Note: This PAR-Q is valid for the entirety of a gym membership from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the 7 questions.
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