=a PAR-Q & YOU (A Questionnaire for People Aged 15 to 69) Regular physical act is fun and heathy. and increasingly more people ae starting to become more active every day. Being more active is very sae for most ‘people, However, some peopl should check with ther ctor before the start becoming much more physical active. IF you are planning to become much more physical active than you ae naw, start by answering the even questions inthe box below. Ifyou are between the ages of 15 and 69, the PAR-Q wil tell you you should check with your doctor before you start. Ifyou are over 69 years of age, and you are nt used ta being very active, check with your decor. ‘Common sense is your best guide when you answer these questions Please read the questions carefully and answer each one honesty 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? in in your chest when you do physical activity? In the past month, have you had chest pain when you were not physical activity? 155 or do you ever lose consciousness? Do you lose your balance because of Do you have a bone or joint problem (for example, back, kn change in your physical activity? 6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart con- dition? 3 hip) that could sade worse by a O o oooo og RM RM RRR KE Do you know of any other ason why you should not do physical activity? If YES to one or more questions Talk wth your decor by phone orn person BEFORE you start becoming much mocephyscaly ace or BEFORE you have ns appraisal. Tell you your dcr about the PARLQ and which questions you answered YES, + Yaumay be able odo ary activity you wart — as long as yu tart lowly andbuld up gradual Or you may ned to esc your actties to 125 wich are sae for you. Tak wth you actor abot the tnd facies you wish o parce in and flo hisher adie answered ‘hse which ar safe fo yu. Tak wth your doctor abou the ids of acts ou wsh to partipat in and fll isher ad + Find ut which community prograns are safe and hep for you A DELAY BECOMING MUCH MORE ACTIVE: wR = Fp tented bern apo oo I you anne NO honesty tall PAF. questions, you canbe early sure that you can: a col ora fever — wat ui you fel beter or + start beconing much nore psa active ~ begin slo an bald up rad. Tis the + i you are or maybe pega — ak your daar bee you safest ard easiest way tg. startbecaing more ave + take partinafiness appraisal ~ isis an exceent way to determine our asic ines so ‘hat you can pan the best way for you tae activ is as highly recommended that you. | PLEASE NOTE: 1 your hea changes so that you hen araner VESTS have your Hood pressure evaated. Ifyou reading ovr 14/94, ak wth yur doctor ‘any ofthe above questions, ll your ness or heath proesioa before you start beconing much more physical ace. Askueter you sould change your ysl acy plan, Inara eal he HR The ann Sec fr xe Pylon Heath anc he gets simon bye prs oun sal acy. and in ot ae completing ‘hs esr, cast yor dcr pro ysl acy No changes permitted. You are encouraged to photocopy the PAR-Q but only if you use the e ire form. [NGTE: Fite PARI ang ano = peso bbe he or she pacha aa ysl ahi rogfan 2 ness aaa is secon maybe used regal or avs pases "Ihave rea, understood and completed this questionaire, Any questions | had were answered tomy ful satisfaction.” FOR rpc de eae Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and ‘becomes invalid if your condition changes s0 that you would answer YES to any of the seven questions Health Santé Canada Canada continued on other side. CinaseSatey tartare doy Sporty