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Classes

Please complete this form before attending your FIRST class

Physical Activity Readiness Questionnaire (PAR-Q)

Please read each question carefully and answer each one honestly.

This questionnaire is to be used by individuals between the ages of 15 and 69.

If you are over the age of 69 please check with your doctor before participating in NEW physical activity IF YOU ARE NOT USED TO PHYSICAL ACVTIVITY.

Has your doctor ever said that you have a heart condition AND that you should only do physical activity recommended by a doctor?
Yes
No
Do you feel pain in your chest when you do physical activity?
Yes
No
In the past month, have you had chest pain when you are not doing physical activity?
Yes
No
Do you lose your balance because of dizziness or do you ever lose consciousness?
Yes
No
Do you have a bone or joint problem that could be made worse by a change in your physical activity? (eg: back, hip or knee)
Yes
No
Is your doctor currently prescribing drugs for your blood pressure or any heart condition?
Yes
No
Do you have any chronic illness or physical limitations such as diabetes or lung conditions (other than controlled asthma)?
Yes
No
Do you know of ANY OTHER REASON why you should NOT do physical activity?
Yes
No
Having read and answered 'YES' to one of the above, I have since sought medical advice and my GP has agreed that I may exercise.
Yes
No
By selecting 'Agree' it will act as my signature on this questionnaire.
Agree
Disagree - I have questions pertaining to this questionnaire

Address

Mill Yard, College Hill,

Penryn, Cornwall TR10 8FN

Opening Hours

Mon & Fri - 11am - 8pm

Wed & Sat - 9am - 8pm
Tue, Thu - 9am - 6pm

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