American University'S Recreational Sports And Fitness Registration Form Page 2

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Recreational Sports and Fitness
Physical Activity Readiness Questionnaire (PAR-Q)
Name of participant______________________ Signature______________________ Date_______________
PAR-Q & You
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.
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
**If you check YES to any of these questions you will be required to have your physician complete a physician’s
clearance form.***
Yes
No
1. Has your doctor ever said you have a heart condition and that you should only do physical activity
recommended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you were not doing physical activity?
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
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?
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart
condition?
7. Do you know of any other reason why you should not do physical activity?
If you answered,
Yes to one or more questions
No honestly to all questions
You can be reasonably sure that you can:
Talk with your doctor by phone or in
 Start becoming much more physically
person BEFORE you start becoming much
active – begin slowly and build up
more physically active or BEFORE you
gradually. This is the safest and
have a fitness appraisal. Tell your doctor
easiest way to go.
about the PAR-Q and which questions you
 Take part in a fitness appraisal – this
answered YES.
is an excellent way to determine your
basic fitness so that you can plan the
best way for you to live actively. It is
also highly recommended that you
have your blood pressure evaluated. If
 You may be able to do any activity you
your reading is over 144/94, talk with
want – as long as you start slowly and
your doctor before you start becoming
build up gradually. Or, you may need to
much more physically active.
restrict your activities to those which are
safe for you. Talk with your doctor
Delay Becoming Much More Active:
about the kinds of activities you wish to
 If you have a temporary minor illness,
participate in and follow his/her advice.
such as a cold or fever.
 Find out which programs are safe and
 If you are or may be pregnant. Talk
helpful for you.
with your doctor first.

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