Physical Activity Readiness Questionnaire (Par-Q) Template


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Physical Activity Readiness Questionnaire (PAR-Q)
PAR-Q is designed to help you help yourself. Many health benefits are associated with regular exercise,
and the completion of PAR-Q is a sensible first step to take if you are planning to increase the amount of
physical activity in your life.
For most people, physical activity should not pose any problems or hazard. PAR-Q has been designed to
identify the small number of adults for whom physical activity might be inappropriate or those who
should have medical advice concerning the type of activity most suitable for them.
Common sense is your best guide in answering these few questions. Please read the carefully and check
YES or NO opposite the question if it applies to you. If yes, please explain.
1. Has your doctor ever said you have heart trouble? If yes, please state:
2. Do you frequently have pains in your heart and chest? If yes, please state:
3. Do you often feel fain or have spells of severe dizziness? If yes, please state:
4. Has a doctor ever said your blood pressure was too high or too low? If yes, please state:
5. Have you had any operations in the last year? If yes, please state:
6. Has your doctor ever told you that you have a bone or joint problem(s),
such as arthritis that has been aggravated by exercise, or might be made worse with exercise?
If yes, please state:
7. Is there a good physical reason, not mentioned here, why you should not follow an activity
program even if you wanted to? If yes, please state:
8. Have you had any injuries? If yes, please state:
7. Are you pregnant or postnatal?
8. Do you suffer from any problems of the lower back, i.e., chronic pain, or numbness?
If yes, please state:
9. Are you currently taking any prescribed medications or dietary supplements? If YES, please
10. Do you currently have any other medical conditions not previously mentioned? If yes, please
Please turn over


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