Physical Activity Readiness Questionnaire "*" indicates required fields Name* First Last EmailPlease enter your email address if you would like to receive a copy of your questionnaire response. Enter Email Confirm Email 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*Please selectNoYes2. Do you feel pain in your chest when you do physical activity?*Please selectNoYes3. In the past month, have you had chest pain when you were not doing physical activity?*Please selectNoYes4. Do you lose your balance because of dizziness or do you ever lose consciousness?*Please selectNoYesMore info losing your balance because of dizziness can be found here. 5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?*Please selectNoYes6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?*Please selectNoYes7. Do you know of any other reason why you should not do physical activity?*Please selectNoYesIf the answer to any of the above questions is YES, please seek medical advice before participating in any exercise programme. By signing this PAR-Q, you are confirming that to the best of your knowledge you know of any reason why you should not be able to perform physical activity. Signature*Date* DD slash MM slash YYYY EmailThis field is for validation purposes and should be left unchanged.