G Sports Club PAR Questionnaire

Are you physically ready?

Regular exercise is associated with many health benefits, yet any change of activity may increase the risk of injury. Completion of this questionnaire is a first step when planning to increase the amount of physical activity in your life. Please read each question carefully and answer every question honestly.

Has a physician ever said that you have a heart condition and that you should only do physical activity recommended by a physician?

Yes

Do you feel pain in your chest when you do physical activity?

Yes

In the past month, have you had chest pain when you were not doing physical activity?

Yes

Do you lose your balance because of dizziness or do you ever lose consciousness?

Yes

Do you have a bone or joint problem that could be made worse by a change in your activity?

Yes

Are you pregnant or post-partum?

Yes

Do you have insulin dependent diabetes?

Yes

Do you have asthma, COPD, or any respiratory disorder that could be made worse with exercise?

Yes

Do you know of any other reason why you should not do physical activity?

Yes

If you said YES to one or more questions:

Talk to your physician by phone or in person BEFORE you start becoming more physically active. Tell your physician about the questionnaire and the questions which you answered yes. You may be able to do any activity you want - as long as your start slow and progress gradually. Or you may need to restrict your activities to those which are safe for you. Follow your physician's advice about the kids of activities recommended.

If you said NO to all questions:

If you honestly answered no to all questions, you can be reasonably sure that you can start becoming more physically active and begin to take part in a fitness training program. Remember to start slow and build up gradually.

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

G Sports Club PAR Questionnaire

Physical Activity Readiness Questionnaire