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REVERE
Fitness
PAR-Q+
Physical Activity Readiness Questionnaire · Required
★ This form is required by law before commencing any exercise programme.
The PAR-Q+ is the internationally recognised pre-participation health screening tool for exercise. It helps identify individuals who may need medical clearance before beginning a programme. Please answer all questions honestly. If you are unsure about any question, answer Yes.
Part 1 — General Health
1 Has your doctor ever said that you have a heart condition or high blood pressure? Yes No
2 Do you feel pain in your chest at rest, during daily activities, or when doing physical activity? Yes No
3 Do you lose balance because of dizziness, or have you lost consciousness in the last 12 months? Note: Answer No if dizziness was related to over-breathing including vigorous activity. Yes No
4 Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)? Yes No
5 Are you currently taking prescribed medication(s) for a chronic medical condition? Yes No
6 Do you currently have (or have had within the past 12 months) a bone, joint, or soft-tissue problem that could be made worse by becoming more physically active? Note: Answer No if you had a problem in the past but it does not limit your current ability to exercise. Yes No
7 Has your doctor ever said that you should only do medically supervised physical activity? Yes No
Part 2 — Follow-Up (if you answered YES to any question above)

Please provide additional details for any "Yes" answers:

Important: If you answered YES to any of the questions above, you should consult your doctor before becoming more physically active or before completing a fitness assessment. Your trainer may require written medical clearance before commencing your programme. You are encouraged to complete a PARQ+ follow-up form with your healthcare provider.
Part 3 — Pregnancy
8 Are you currently pregnant, or have you given birth in the last 12 months? Yes No
Declaration

I have read, understood, and accurately completed this questionnaire. I understand that this pre-exercise screening is designed for my safety and to help my trainer provide appropriate programming. I confirm that any "Yes" answers have been disclosed and I will inform my trainer of any subsequent changes to my health.