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Additional Required Information

Physical Activity Readiness Questionnaire (PAR-Q)

Please fill in the questions below:



Questions

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Tell your physician which questions you answered “Yes” to. After a medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition. If your condition changes throughout the exercise program such that you would answer “Yes” to any of these questions, consult your physician before continuing.


Occupational Questions

Yes No

Yes No

Yes No



Medical Questions

Yes No

Yes No



Recreational Questions



Yes, I confirm

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