1-1 in Gym

The PAR-Q+

Purpose: To ensure it is safe for you to become more physically active or undergo a fitness appraisal.

Instructions: Please read the questions below carefully and answer each one honestly. Check YESor NO.

PART 1:

1. Has your doctor ever said that you have a heart condition OR high blood pressure?

2. Do you feel pain in your chest at rest, during daily activities, or when you do physical activity?

3. Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months?

4. Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure), such as Type 1 or 2 diabetes, asthma, COPD, or cancer?

5. Are you currently taking prescribed medications for a chronic medical condition?

6. Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active?

7. Has your doctor ever said that you should only do medically supervised physical activity?

If you answered NO to all questions:
You can be reasonably confident that you can safely take part in physical activity and a fitness appraisal. It is still advisable to start slowly and increase gradually.

If you answered YES to one or more questions:
You may need to seek medical advice or use caution before becoming more active. Proceed to PART 2 below.

PART 2: Follow-Up Questions (For those who answered YES above)

This section helps determine if you need to see a doctor before exercising.

Chronic Medical Conditions:

• Is your condition better controlled because of your medication or treatment?

• Are you aware of any signs or symptoms that indicate your condition is getting worse?

• Do you know the recommended physical activity for your condition?

Musculoskeletal Problems:

• Do you have pain or an injury that gets worse when you are physically active?

• Have you seen a healthcare professional for this issue?

Symptoms:

• Do you experience unusual shortness of breath or fatigue during mild physical activity?

• Do you experience swelling in your ankles or unexplained weight loss/gain?

Pregnancy:

• Are you pregnant or have you given birth within the last 4 months?

General Recommendations Based on Your Answers:

• All NO in Part 1: You are likely cleared to begin a gradual exercise program.

• YES in Part 1, but condition is well-controlled and you have no worsening symptoms (from Part 2): You may begin light-to-moderate activity but should monitor symptoms and progress slowly. Consulting a doctor is still a good idea.

• YES in Part 1, and you have new/worsening symptoms, pain, or poor control of your condition:You should consult with your doctor or a qualified healthcare professional before starting any exercise program. Show them this completed questionnaire.

Important Disclaimer:

This questionnaire is a screening tool, not a medical diagnosis. It is designed for individuals aged 15 to 69. If you are over 69 or have specific health concerns not covered here, consulting a doctor is essential.

When in doubt, seek medical advice.

Next Steps Before You Start:

1. Get Clearance (if needed). If the questionnaire indicates you should see a doctor, do so.

2. Set Realistic Goals. Start with achievable goals (e.g., 10-minute walks, 2 days per week).

3. Choose Activities You Enjoy. You're more likely to stick with it.

4. Listen to Your Body. Stop immediately and seek medical attention if you experience:

   • Chest, neck, jaw, or arm pain or pressure

   • Severe shortness of breath

   • Dizziness or faintness

   • Extreme joint pain

Sign and Date (if using formally):
I have read, understood, and completed this questionnaire. I confirm that my answers are true to the best of my knowledge.

Name: ________________________

Signature: ________________________ Date: //____

Remember: The goal is to help you exercise safely. Taking a few minutes to complete this can prevent injuries and health complications, setting you up for long-term success.