Republic of the Philippines

Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF TARLAC PROVINCE
VICTORIA NATIONAL HIGH SCHOOL SHS
SAN GAVINO, VICTORIA TARLAC

Name: _________________________________________ Date: ________

Grade/Strand/Section: __________________________

Health Optimizing Physical Education 1

NOTE: Assess your readiness in physical activities by putting a check mark in the column. Do this before
performing such physical activity.

(READINESS QUESTIONNAIRE)

Assess readiness for participation in physical activities by taking the Physical Activity
Readiness Questionnaire (PAR-Q)

QUESTIONS YES NO
1. Has your doctor ever said that you a heart condition and that you
should only do physical activity recommended by a doctor?
2. Do you feel 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 you balance because of dizziness or do you ever lose
consciousness?
5. Do you have boner or joint problem 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 any the reason why you should no do physical activity?