Please complete this form if you are interested in receiving a nutrition consultation.
For most people physical activity should not pose any problem or hazard. The Physical Activity Readiness Questionnaire has been designed to identify the small number of adults for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity most suitable for them. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly.
Has your doctor ever said you have a heart condition AND that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs (for example: water pills) for your blood pressure or heart condition?
Do you know of ANY OTHER REASON why you should not do physical activity?
Talk with your doctor and have them fill out a Report of Physical Examination form (available at Guest Service) BEFORE you participate in a personal fitness training or fitness assessment. Tell your doctor about the PAR-Q and which questions you answered yes to.
Start becoming more physically active, beginning slowly and building up gradually. This is the safest and easiest way to go. Take part in personal fitness trainer or fitness assessment appointment; this is an excellent way to determine your basic fitness so you can plan the best way for you to live actively. You should delay becoming more physically active if you are not feeling well because of temporary illness such as a cold or fever OR if you are or may be pregnant. Please consult your physician before coming physically active.
Be sure to indicate both the condition and the person.
Examples include: Tonsilitis, Bladder or Ear Infection, Vaginitis, Colitis, Sinusitis, Yeast Overgrowth, Mastitis, Dental Abscesses, etc
Examples include: Asthma, Bronchitis, Pneumonia, etc.
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