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Personal Trainer PAR-Q

(Physical Activity Readiness Questionnaire)

Birthday
Day
Month
Year
Gender
Male
Female
Other

Medical History

Do you have a heart condition?
Yes
No
Do you feel pain in your chest when you perform physical activity?
Yes
No
In the past month, have you had chest pain when you were not performing any physical activity?
Yes
No
Do you lose your balance because of dizziness, or do you ever lose consciousness?
Yes
No
Do you have a bone or joint problem that could be worsened by a change in your physical activity?
Yes
No
Is your doctor currently prescribing any medication for your blood pressure or a heart condition?
Yes
No
Do you know of any other reason why you should not engage in physical activity?
Yes
No

Lifestyle and Physical Activity Readiness

How would you rate your current physical activity level?
Sedentary
Moderately Active
Active
Very Active

What are your fitness goals? (e.g., weight loss, muscle gain, endurance improvement)

Have you engaged in regular exercise in the last 6 months?
Yes
No
Are there any specific exercises or activities you are unable to perform?
Yes
No

Acknowledgment and Consent

Date
Day
Month
Year

Note to Trainer: Assess the information provided and discuss any concerns orprecautions with the client before commencing any physical activity program. In cases where medical conditions are present, it may be advisable to seek clearance from a healthcare professional.

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