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PARQ
PAR-Q
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor.
Name
*
First Name
Last Name
Email Address
*
Gender
*
SELECT
MALE
FEMALE
Date of birth
*
MM
DD
YYYY
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.
1. 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
2. Do you feel pain in your chest when you do physical activity?
*
YES
NO
3. In the past month, have you had chest pain when you were not doing physical activity?
*
YES
NO
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
*
YES
NO
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?
*
YES
NO
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
*
YES
NO
7. Do you know of any other reason why you should not do physical activity?
*
YES
NO
Resting Heart Rate (RHR)
*
Blood pressure
*
Use the following format XXXYY. If your blood pressure is 120/80, please write 12080
Weight in pounds (lbs)
Thank you!
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