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PAR-Q Medical Status

Being more active is very safe for most people. However, some people should check with their doctor before they start
becoming much more active. If you are planning to become much more physically active, start by answering the seven
questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your
doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor

Common sense is your best quide when you answer these questions. Please read the question carefully and answer each
one honestly: place a tick in the space to the left of the question to answer "yes" or "no". Please
ask if you have any questions. Your responses will be treated in a confidential manner.


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


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


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


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


Do you have a bone or joint problem that could be made worse by a change in your blood pressure or heart condition?


Is your doctor currently prescribing drugs (for example, waterpills) for your blood pressure or heart condition?


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

If you answered YES to one or more questions , talk with your doctor by phone or in person BEFORE you start becoming
much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which
questions your answered YES. You may be able to do any activity you wnat- as long as you start slowly and build up
gradually. Or, you may need to restrict your activities to those that are dafe fdor you. Talk with your doctor about the kinds
of activities you wish to participate in and follow his/her advice.

If you answered NO honestly to all questions, you can be reasonably sure that you can:

-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 fo ryou to live actively.

Even if you answered no to all questions, you should delay becoming much more active:
-If you are not feeling well because of a temporary illness such as a cold or a fever-wait until you feel better.
-If you are of may be pregnant-talk to your doctor before you start becoming more active.

Please note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask weather you should change your physical actvity plan.

Informed use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity. If in doubt after completing this questionnaire, consult your doctor prior to physical activity.

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



Todays Date:_____________/_____________/___________

Signature of Parent/Guardian___________________________________
(for participants under the age of majority)