Free template

Pre-exercise screening (PAR-Q)

The standard seven readiness questions, on one printable page. Any 'yes' means a conversation with a doctor before hard training — that's the whole tool.

About you

Full name
Date of birth

Screening questions

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

YesNo

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

YesNo

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

YesNo

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

YesNo

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

YesNo

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

YesNo

7. Do you know of any other reason why you should not do physical activity?

YesNo

If you answered yes to any question

Talk with your doctor before becoming much more physically active, and tell them which questions you answered yes to. Training can almost always continue — the point of this form is that it continues with the right information.

Notes / doctor's guidance

Declaration

I have read, understood and answered every question honestly. I understand this questionnaire is a screening tool, not medical advice, and that I should tell my trainer if my health changes.

Signature
Date

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