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Physical Activity Readiness Questionnaire (PAR-Q)

​This PAR-Q is designed to help you to help yourself. Many benefits are associated with regular exercise, and completion of the PAR-Q form is a sensible first step to take if you are planning to increase the amount of physical activity in your life. For most people, physical activity should not pose a problem or hazard. The PAR-Q has been designed to identify the small number of people for whom physical activity might be inappropriate or for those who should seek medical advice concerning the type of activity most suitable for them. Common sense is your best guide for answering these questions.

If you have answer NO to all the questions and you have reasonable assurance of your suitability for exercise, sign the Participant Declaration below.

  • It is advised that you consult a qualified exercise professional to help you develop a safe and effective physical activity plan to meet your health needs.

  • You are encouraged to start slowly and build up gradually - 20 to 60 minutes of low to moderate intensity exercise, 3-5 days per week including aerobic and muscle strengthening exercises.

  • If you are over the age of 45 years and NOT accustomed to regular vigorous to maximal sort exercise, consult a qualified exercise professional before engaging in this intensity of exercise.

 

If you answer YES to any of the questions below, you are required to gain consent from your doctor before participating in the group exercise session. Delay becoming more active if:

  • You have a temporary illness such as a cold or fever; it is best to wait until you feel better.

  • You are pregnant - talk to your health care practitioner, your physician, a qualified exercise professional, before becoming more physically active.

  • Your health changes - talk to your doctor or qualified exercise professional before continuing with any physical activity program.

 

All persons who complete the PAR-Q+ please read and sign the declaration below. If you are less than the legal age required for consent or require the assent of a care provider, your parent/guardian or care provider must also sign this form. Please note that no liability is accepted for any loss of or damage to any articles, which you may bring with you to classes. Equally, liability is not accepted for loss of or damage to motor vehicles or their contents and these are left at the owner’s risk.

1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Yes
No
2. Do you feel pain in your chest when you do physical activity?
Yes
No
3. In the past month, have you had chest pain when you were not doing physical activity?
Yes
No
4. Do you lose your balance because of dizziness or do you ever lose consciousness?
Yes
No
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in physical activity?
Yes
No
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Yes
No
7. Do you know of any other reason why you should not do physical activity?
Yes
No
Participant Declaration
I agree
I do not agree

I confirm that where any medical condition, discomfort or injury which may be affected by physical activity applies or becomes applicable at any time when I am participating in a class, I am responsible for checking with my doctor to ensure I am able to participate in this activity.

Anna Seeley Pilates​

Worcester Park, KT4 7QF

+44 (0)7846 673836

Info@annaseeleypilates.com

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Anna Seeley Pilates is a boutique Reformer Pilates studio in Worcester Park, offering personalised one-to-one and small group sessions in a peaceful garden studio. We welcome clients from Worcester Park, Ewell, North Cheam, Tolworth, Stoneleigh, Chessington and the surrounding areas. Whether you're a beginner, recovering from injury, navigating menopause or looking to improve your strength, every session is tailored to you - your body, your goals and your pace.

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