Physical Activity Readiness Questionnaire

(PAR-Q)

The Physical Activity Readiness Questionnaire (PAR-Q) is a common method

of uncovering health and lifestyle issues prior to an exercise program starting. The
questionnaire is short and easy to administer and reveals any family history of illness. If
the PAR-Q reveals an issue it is advisable for you to seek a doctor's advice through a
process called the GP referral.

Personal trainers or P.E. teachers often use the PAR-Q to identify any reasons
why their students shouldn't start a course of physical exercise. A PAR-Q highlights any
medical conditions or physical inabilities that a student may need to speak to their
teachers about and that the teachers may need to consider during training. From a
liability point of view, the PAR-Q reduces the risk of client injury, illness, and even
accident.

Why do you need to complete a PAR-Q?

It is advised that each personal trainer or P.E. teacher should produce their PAR-
Q relating to the type of activity they provide and a set of guidelines stating what action
should be taken if a person gives a 'negative' response PAR-Q. This might include
advising the person to speak to their teachers or adapting the exercise plan to
incorporate their specific requirements. In extreme cases, teachers may have to deny a
person to continue the activity to prevent client injury or incident.

For example, if someone failed to ask the person to complete a PAR-Q and
suffer an injury due to a previous condition or troublesome body part, problems could
ensue. Teachers could be blamed for asking a student to undertake an activity that they
were not physically able to do so. This may be seen as negligence on the teacher's part.

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 more physically
than you are now, start by answering the seven questions in the box below.
 Common sense is your best guide when you answer these questions.
Please read questions carefully and answer each one honestly: check YES or NO.

PAR-Q
Physical Activity Readiness Screening Form

Student Information:
Date: December 8, 2023

Name: Erina May B. Orpina

Course and Section: PE002-C186

Instructor: Ma’am Rhea Lanticse

Emergency Contact Details:

Name: Ana Liza B. Orpina

Contact No: 0951 093 6207

Relationship: Mother

The health benefits of regular physical activity are clear; more people should engage
in physical activity every day of the week. Participating in physical activity is very
safe for MOST people. This questionnaire will tell you whether it is necessary for you
to seek further advice from your doctor or your teacher before becoming more
physically active.

Instruction: Please read the questions carefully and answer

each one honestly: Check YES or NO
YES NO
NOTE: For students with medical issues, a medical
certificate from your doctor or from the school clinic
should be attached.

Has your doctor ever said that you have a heart condition or 
high blood pressure?


Do you feel pain in your chest at rest, during your daily
activities of living, or when you do physical activity? 

Do you lose balance because of dizziness, or have you lost

consciousness in the last 12 months?


Note: Please answer NO if your dizziness was associated
with over-breathing (including during vigorous exercise)

Have you ever been diagnosed with another chronic medical

condition (other than heart disease or high blood pressure)?

PLEASE LIST CONDITIONS(S) HERE:



Do you have a bone or joint problem (for example back, neck,

knee, or hip) that could be made worse by a change in your
physical activity? 

Do you have asthma or respiratory problem? 

Do you have epilepsy? 

Do you know of any other reason why you should not do

physical activity?

Explain:
_________________________________________________
_ _

If you answered YES to one or more NO to all questions

questions

Go to school clinic and talk with the If you answered NO honestly to all PAR-
doctor before you start becoming more Q questions, you can be reasonable sure
physically active or before you have a that you can:
fitness appraisal. Tell the doctor about
the PAR-Q and which questions you
answered YES.
• You may be able to do any activity
you want – as long as you start
slowly and build up gradually. Or you
may need to restrict your activities to
those that are safe for you. Talk with
the doctor about the kinds of activities
you wish to participate in and follow
his or her advice.
Find out which physical activity program
are safe and helpful for you.
• Start becoming much more physically
active – begin slowly and build up
gradually. This is the safest and
easiest way to go.
• Take part in a fitness appraisal – this
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
your reading is over 144/94, talk with
your doctor before you start becoming
much more physically active.
Delay becoming much more active:
• If you are not feeling well
because of a temporary illness
such as a cold or fever – wait
until you feel better; or
• If you are or may be pregnant –
talk your doctor before you start
becoming more active.
Please note: If your health changes so
that you then answer YES to any above
questions, tell your teacher. Ask whether
you should change your physical activity
plan.