PAR-Q Form

Before you can take part in any of our fitness classes, you must complete our Physical Activity Readiness Questionnaire (PAR-Q). This form helps us ensure that our sessions are safe and suitable for you by identifying any health conditions or concerns that may affect your ability to exercise. Please complete the form before your first class – it’s quick and easy but essential for your safety. No completed PAR-Q, no participation. Thank you for your cooperation!

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Name *

First

Last

Email *

Phone Number *

Date of Birth *

Gender

• Male
• Female
• Non-binary
• Genderqueer
• Genderfluid
• Agender
• Bigender
• Transgender
• Other

Do you have a heart condition or cardiovascular disorder? *

• Yes
• No

Did the doctor advised you to limit physical activity and only perform the recommended activities by the professional? *

• Yes
• No

Is there any chest pain when your doing any physical activity? *

• Yes
• No

In the past month, did you experience any pain in the chest area when you're not doing anything? *

• Yes
• No

Do you usually lose your balance due to being dizzy or even lose your consciousness? *

• Yes
• No

any reason you

Are you experiencing bone or joint problems that worsens if you change your physical activity? *

• Yes
• No

Are you currently taking medications for your blood pressure or heart condition? *

• Yes
• No

Is there any reason why you should not do physical activities? *

• Yes
• No

If you’re answer is “NO” to all of the questions above, then you are safe to participate in physical activities. If you answer “YES” to one or more questions, then you need to consult your doctor to clarify if you’re capable of doing physical activities on your current state.

Emergency Contact Person *

First

Last

Phone Number (Emergency Contact) *

I confirm that the information I have provided is accurate and complete to the best of my knowledge. I understand that it is my responsibility to inform Welwyn Fitness of any changes to my health or fitness that may affect my ability to participate in physical activity. *

• Tick to confirm

Submit