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ParQ - Physical Activity Questionairre

Please completer this from prior to attending your first session.

ParQ (Physical Activity Readiness Questionaire)

For your own saftety, please take a minute to fill in the following information prior to joining our live or online fitness sessions. If you are using the free online sessons you do so at your own risk.

Birthday
Has your doctor advised you not to particpate in exercise?
Do you feel pain in your chest at rest or when you do physical activity?
Do you lose your balance because of dizziness or do you ever black out?
Do you get short of breath at rest or doing light activity?
Do you have a heart condition? (e.g. angina, palpitations, atrial fibrillation or have you ever had a heart attack?)
Have you ever had a stroke or a mini stroke?

If you answered YES to any of the above please ask your GP/health care professional before participating. By signing below you indicate you have permission to participate.

Do you have any difficulties with your breathing such as COPD, emphysema, chronic bronchitis, astma or any lung condition?
Do you have diabetes, high blood pressure or epilepsy? If yes please indicate which below.
Do you have any bone, joint, muscular or neurological conditions which affect your ability to exercise such as osteoporosis, back pain, multiple sclerosis, Parkinsons or arthritis? Include and joint replacements.
Have you had an operation in the last 3 months?
Have you had a fall in the last 12 months?
Do you have (or have you had) cancer?
Do you have any allergies including latex?
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