PAR-Q | The Core Society

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Health & Wellbeing Questionnaire (PAR-Q)

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

YES

NO

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

YES

NO

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

YES

NO

Do you lose your balance because of dizziness, or have you ever lost consciousness?

YES

NO

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

YES

NO

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

YES

NO

Do you know of any other reason why you should not take part in physical activity?

YES

NO

If you answered YES to any of the questions above, please provide details:

Is there anything else relating to your health, mobility, injuries or physical activity that you would like your instructor to be aware of?

I confirm that the information I have provided is accurate to the best of my knowledge. I understand that I am responsible for informing The Core Society of any changes that may affect my ability to exercise safely.

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