PHILIPPINE PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (Bonoan & Bernardo, 2006) please read the questions carefully, and answer each one honestly. Bosahin nang mabuti ang mga tanong, at sagutin nang buong katapatan. Yes (00) NO (Hindi) ‘Has your doctor ever diagnosed you with a heart condition and that you’ should only do physical activity recommended by a doctor? (Sinabihan ka na ba ng doktor mo na ikaw ay may karamdaman sa puso at ang dapat mo lang gawing pisikal na aktibidad ay ang rekomendado ng doktor?) 's your doctor currently prescribing drugs for your blood pressure or heart condition? (Kosalukyyan ka bang pinapainom ng gamot na inireseta ng doktor mo para| sa mataas na presyon ng dugo 0 karamncaman sa puso?) Do you experience pain or discomfort in the chest, neck, and jaw area during ‘mild physical activity or at rest? (Nakakaramdlam ka ba ng sakit o karamdaman sa dibalb, teeg, o gawing panga habang qumagawa ing maaan na gawaing pls o kaya ay nagpapahinga?) |yes | No (00) | (Hinaly o you! experience shortness of breath with mild physical exertion? (Nakakaramdom ka ba ng kahlrapan so paghinga habang gumagawa ng | ‘magaan na gowaing pistkal) ‘Do you get Uired frequently even when not doing physical activity, or are you frequently drowsy? (Madotas ka bang napopagod maski na walang glnagawans piskal, @ madalas a bang nananamay?) Have you lost weight rapidly recently with or without feelings of extreme unger? (Namayat 0 nawatan ko ba ng timbong nang sobrang bits komakaiian nang ‘indi nakararamdam ng matinding gutom?) Do you have @ bone or joint pain that increases with movement? Is there a suclden increase in pain when bending or touching the joint? (Nakokaramdom ka ba ng sakit sa buto 0 fasu-kasuon na lumalale kapog -gumalaw? May bigiang pagtindi ba ng sakit kung binabatuktot o hinahawakan ‘ang kasu-kasuan?) ‘Do you know of any other reason you should not do physical activity? (Meron ka bang alam na iba pang dahitan kung bakit hindi ka dapat gumawa ‘ng kahit ano mang gowaing pisikal?) I you answered YES to any question, please see an EIN certified specialist. Thank you, (Kopag may sinagutan ka ng Oo, macari tang magpakite so EWM certified specialist. Salamat,) Student's Name: —_—_—_______ Date. Parent/Gurdian's Narne: —_______ Date: CCeatance Recommendations: Please puta mar (7 of X) inside the box. (1 HerShe is cleared to participate in an unrestricted activity. (C1 He/She is cleared to participate ina ight co moderate activity only [FJ He/She should not participate in any activity at this time pending further evaluation, Others; Please pecifyg Signature of Physician: Date