The Physical Activity Readiness Questionnaire (PAR-Q+)

The Physical Activity Readiness Questionnaire for Everyone

Regular physical activity is fun and healthy, and more people should become more physically active every day of the week. Being more physically active is very safe for MOST people. This questionnaire will tell you whether it is necessary for you to seek further advice from your doctor OR a qualified exercise professional before becoming more physically active.

Declaration 

  • You must use the entire questionnaire and NO changes are permitted.
  • The Canadian Society for Exercise Physiology, the PAR-Q+ Collaboration, and their agents assume no liability for persons who undertake physical activity. If in doubt after completing the questionnaire, consult your doctor prior to physical activity.
  • If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian or care provider must also sign this form.
  • Please read and initial the declaration below:

I this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that a Trustee (such as my employer, community/fitness centre, health care provider, or other designate) may retain a copy of this form for their records. In these instances, the Trustee will be required to adhere to local, national, and international guidelines regarding the storage of personal health information ensuring that they maintain the privacy of the information and do not misuse or wrongfully disclose such information.

Initial Here

 

Signee Information

SECTION 1 - GENERAL HEALTH

Please read the 7 questions below carefully and answer each one honestly: check YES or NO.






















If you answered NO to all of the questions above, you are cleared for physical activity. Go to the bottom to sign the form. YOU DO NOT NEED TO COMPLETE Section 2.

If you answered YES to one or more of the questions above, please GO TO SECTION 2.

SECTION 2 - CHRONIC MEDICAL CONDITIONS

Please read the questions below carefully and answer each one honestly: check YES or NO.







(Answer NO if you are not currently taking medications or other treatments)






















(Answer NO if you are not currently taking medications or other treatments)










(Answer YES if you do not know your resting blood pressure)










(Answer YES if you are not sure)













(Answer NO if you are not currently taking medications or other treatments)










(Answer NO if you are not currently taking medications or other treatments)
















(Answer NO if you are not currently taking medications or other treatments)













(Answer NO if you are not currently taking medications or other treatments)



















Please read these recommendations for your current medical condition and sign this document.

Delay becoming more active if:

You are not feeling well because of a temporary illness such as a cold or fever – wait until you feel better You are pregnant – talk to your health care practitioner, your physician, a qualified exercise professional, and/or complete the PARmed-X for Pregnancy before becoming more physically active OR Your health changes – please answer the questions on Section 2 of this document and/or talk to your doctor or qualified exercise professional (CSEP-CEP or CSEP-CPT) before continuing with any physical activity programme.

If you answered NO to all of the follow-up questions about your medical condition, you are ready to become more physically active.

If you answered YES to one or more of the follow-up questions about your medical condition:

You should seek further information from a licensed health care professional before becoming more physically active or engaging in a fitness appraisal and/or visit a or qualified exercise professional (CSEP-CEP) for further information.

Sign Here

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.