The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) is a tool designed to help individuals determine their readiness for physical activity and identify those who should seek medical advice before becoming more physically active. It underscores the health benefits of regular physical activity while ensuring safety. To assess your physical activity readiness and take a step towards a healthier lifestyle, click the button below to fill out the form.
Understanding the significance of physical activity in maintaining and enhancing one's health is essential, and the Activity Parq form, or the Physical Activity Readiness Questionnaire for Everyone (2021 PAR-Q+), serves as a foundational step for individuals contemplating increased physical engagement. Its primary objective is to determine whether an individual should consult a healthcare professional before initiating a new or more demanding physical activity regimen. Through a series of carefully crafted questions, the form scrutinizes various health aspects, including heart conditions, chest pain, balance issues, chronic medical conditions, prescribed medications, bone or joint problems, and medically supervised activity recommendations. Respondents are guided to answer with a simple 'Yes' or 'No,' facilitating an uncomplicated self-assessment process. The questionnaire emphasizes the safety of physical activity for most individuals while underscoring the importance of medical guidance for those with pre-existing conditions. Furthermore, the PAR-Q+ introduces a participant declaration, underscoring the personal acknowledgment of the questionnaire's completion and the understanding of its implications for physical activity clearance, valid for up to 12 months unless one's health status changes. By addressing a comprehensive list of health questions, the PAR-Q+ plays a pivotal role in promoting safe physical activity participation, aligned with global physical activity guidelines, and underscores the need for individualized assessment in the pursuit of health and fitness goals.
2021 PAR-Q+
The Physical Activity Readiness Questionnaire for Everyone
The health benefits of regular physical activity are clear; more people should engage in physical activity every day of the week. Participating in physical activity is very safe for MOST people. This questionnaire will tell you whether it is necessary for you to seek further advice from your doctor OR a qualified exercise professional before becoming more physically active.
GENERAL HEALTH QUESTIONS
Please read the 7 questions below carefully and answer each one honestly: check YES or NO.
YES NO
1)Has your doctor ever said that you have a heart condition OOR high blood pressure O?
2)Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?
3)Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months?
Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise).
4)Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)? please listcondition(S) here:
5)Are you currently taking prescribed medications for a chronic medical condition?
PLEASE LIST CONDITION(S) AND MEDICATIONS HERE:
6)Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically
active? Please answer NO if you had a problem in the past, but it doesnot limit your current ability to be physically active.
PLEASE LIST CONDITION(S) HERE:
o
7) Has your doctor ever said that you should only do medically supervised physical activity?
If you answered NO to all of the questions above, you are cleared for physical activity.
—I Please sign the PARTICIPANT DECLARATION. You do not need to complete Pages 2 and 3.
Start becoming much more physically active - start slowly and build up gradually.
Follow Global Physical Activity Guidelines for your age (https://www.who.int/publications/i/item/9789240015128).
You may take part in a health and fitness appraisal.
If you are over the age of 45 yr and NOT accustomed to regular vigorous to maximal effort exercise, consult a qualified exercise professional before engaging in this intensity of exercise.
►If you have any further questions, contact a qualified exercise professional.
PARTICIPANT DECLARATION
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.
I, the undersigned, have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
NAME
DATE
SIGNATURE _____________________________________
WITNESS
SIGNATURE OF PARENT/GUARDIAN/CARE PROVIDER
[i® If you answered YES to one or more of the questions above, COMPLETE PAGES 2 AND 3.
/*\ Delay becoming more active if:
You have a temporary illness such as a cold orfever; it is best to wait until you feel better.
You are pregnant - talk to your health care practitioner, your physician, a qualified exercise professional, and/or complete the ePARmed-XT at www.eparmedx.com before becoming more physically active.
Your health changes - answer the questions on Pages 2 and 3 of this document and/ortalkto your doctor ora qualified exercise professional before continuing with any physical activity program.
J
3
01-11-2020
2021 PAR-Qt
FOLLOW-UP QUESTIONS ABOUT YOUR MEDICAL CONDITION(S)
1.Do you have Arthritis, Osteoporosis, or Back Problems?
If the above condition(s) is/are present, answer questions la-lc
If noQ go to question 2
la.
Do you have difficulty control ling your condition with medications or other physician-prescribed therapies?
yesQ NOQ
(Answer NO if you are not currently taking medications or other treatments)
lb.
Do you have joint problems causing pain, a recent fracture or fracture caused by osteoporosis or cancer,
YESQ NOQ
displaced vertebra (e.g., spondylolisthesis), and/or spondylolysis/pars defect (a crack in the bony ring on the
back of the spinal column)?
1c.
Have you had steroid injections or taken steroid tablets regularly for more than 3 months?
2.Do you currently have Cancer of any kind?
If the above condition(s) is/are present, answer questions 2a-2b
If NO O go to question 3
2a.
Does your cancer diagnosis include any of the following types: lung/bronchogenic, multiple myeloma (cancer of
yes[“) NO t-)
plasma cells), head, and/or neck?
u
2b.
Are you currently receiving cancer therapy (such as chemotheraphy or radiotherapy)?
3.Do you have a Heart or Cardiovascular Condition? This includes Coronary Artery Disease, Heart Failure, Diagnosed Abnormality of Heart Rhythm
If the above condition(s) is/are present, answer questions 3a-3d
If NO
go to question 4
3a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
3 b. Do you have an irregular heart beat that requires medical management? (e.g., atrial fibrillation, premature ventricular contraction)
3c. Do you have chronic heart failure?
3d. Do you have diagnosed coronary artery (cardiovascular) disease and have not participated in regular physical activity in the last 2 months?
4.
Do you currently have High Blood Pressure?
If the above condition(s) is/are present, answer questions 4a-4b
If NO O 9° to question 5
4a.
Do you have difficulty controlling your condition with medications or other physician-prescribed therapies?
4b.
Do you have a resting blood pressure equal to or greater than 160/90 mmHg with or without medication?
(Answer YES if you do not know your resting blood pressure)
5.Do you have any Metabolic Conditions? This includes Type 1 Diabetes,Type 2 Diabetes, Pre-Diabetes
If the above condition(s) is/are present, answer questions 5a-5e
If NO [~] go to question 6
5a.
Do you often have difficulty controlling your blood sugar levels with foods, medications, or other physician-
YESQ
NOQ
prescribed therapies?
5 b.
Do you often suffer from signs and symptoms of low blood sugar (hypoglycemia) following exercise and/or
during activities of daily living? Signs of hypoglycemia may include shakiness, nervousness, unusual irritability,
abnormal sweating, dizziness or light-headedness, mental confusion, difficulty speaking, weakness, or sleepiness.
5c.
Do you have any signs or symptoms of diabetes complications such as heart or vascular disease and/or
complications affecting your eyes, kidneys, ORthe sensation in your toes and feet?
5d. Do you have other metabolic conditions (such as current pregnancy-related diabetes, chronic kidney disease, or liver problems)?
5e. Are you planning to engage in what for you is unusually high (or vigorous) intensity exercise in the near future?
<- VI
in □
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6.Do you have any Mental Health Problems or Learning Difficulties? This includes Alzheimer's, Dementia, Depression, Anxiety Disorder, Eating Disorder, Psychotic Disorder, Intellectual Disability, Down Syndrome
If the above condition(s) is/are present, answer questions 6a-6b
If NO O go to question 7
6a.
6b.
Do you have Down Syndrome AND back problems affecting nerves or muscles?
7.Do you have a Respiratory Disease? This includes Chronic Obstructive Pulmonary Disease, Asthma, Pulmonary High Blood Pressure
If the above condition(s) is/are present, answer questions 7a-7d
|f NO Q go to question 8
7a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
7 b. Has your doctor ever said your blood oxygen level is low at rest or during exercise and/or that you require supplemental oxygen therapy?
7c. If asthmatic, do you currently have symptoms of chest tightness, wheezing, laboured breathing, consistent cough (more than 2 days/week), or have you used your rescue medication more than twice in the last week?
7d. Has your doctor ever said you have high blood pressure in the blood vessels of your lungs?
8.Do you have a Spinal Cord Injury? This includes Tetraplegia and Paraplegia
If the above condition(s) is/are present, answer questions 8a-8c
If NO O go to question 9
8a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
8 b. Do you commonly exhibit low resting blood pressure significant enough to cause dizziness, light-headedness, and/or fainting?
8c. Has your physician indicated that you exhibit sudden bouts of high blood pressure (known as Autonomic Dysreflexia)?
9.Have you had a Stroke? This includes Transient Ischemic Attack (TIA) or Cerebrovascular Event
If the above condition(s) is/are present, answer questions 9a-9c
If NO Q go to question 10
9a. Do you have difficulty controlling your condition with medications or other physician-prescribed therapies? (Answer NO if you are not currently taking medications or other treatments)
9 b. Do you have any impairment in walking or mobility?
9c. Have you experienced a stroke or impairment in nerves or muscles in the past 6 months?
YESQ noQ
yesQ noQ
YESQ NoQ
yesQ NoQ
10.Do you have any other medical condition not listed above or do you have two or more medical conditions?
If you have other medical conditions, answer questions lOa-IOc
If NqQ read the Page 4 recommendations
10a.
Have you experienced a blackout, fainted, or lost consciousness as a result of a head injury within the last 12
months OR have you had a diagnosed concussion within the last 12 months?
10b.
Do you have a medical condition that is not listed (such as epilepsy, neurological conditions, kidney problems)?
NoQ
10c.
Do you currently live with two or more medical conditions?
PLEASE LISTYOUR MEDICAL CONDITION(S)
AND ANY RELATED MEDICATIONS HERE:
GO to Page 4 for recommendations about your current medical condition(s) and sign the PARTICIPANT DECLARATION.
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2021 PAR-Ql-
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,
and/or complete the ePARmed-X+ at www.eparmedx.com before becoming more physically active.
Your health changes - talk to your doctor or qualified exercise professional before continuing with any physical activity program.
•You are encouraged to photocopy the PAR-Q+. You must use the entire questionnaire and NO changes are permitted.
•The authors, the PAR-Q+ Collaboration, partner organizations, and their agents assume no liability for persons who undertake physical activity and/or make use of the PAR-Q+ or ePARmed-X+. If in doubt after completing the questionnaire, consult your doctor prior to physical activity.
•All persons who have completed 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.
I, the undersigned, have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center may retain a copy of this form for records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
SIGNATURE
----------- For more information, please contact
www.eparmedx.com
Email: eparmedx^gmailxom
Otttfcn for PAR-O+
Warburton DER, Jamnik VK, Bred in SSD, and Gledhill N on behalf of the PAR-Q+ Collaboration.
The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and Electronic Physical Activity Readiness Medical Examination (ePARmed-X+). Health & Fitness Journal of Canada 4(2)3-23, 2011.
Key Referanees
The PAR-Q+ was created using the evidence-based AGREE process (1) by the PAR-Q+
Collaboration chaired by Dr. Darren E. R. Warburton with Dr. Norman Gledhill, Dr. Veronica Jamnik,and Dr. Donald C. McKenzie (2). Production of this document has been made possible through financial contributions from the Public Health Agency of Canada and the BC Ministry of Health Services. The views expressed herein do not necessarily represent the views of the
Public Health Agency of Canada or the BC Ministry of Health Services.
1.Jamnik VK, Warburton DER, Makarski J, McKenzie DC, Shephard RJ, Stone J, and Gledhill N. Enhancing the effectiveness of clearance for physical activity participation; background and overall process. APNM 36(S1):S3-S13, 2011.
2.Warburton DER, Gledhill N,JamnikVK, Bredin SSD, McKenzie DC, Stone J, Charlesworth S, and Shephard RJ. Evidence-based risk assessment and recommendations for physical activity clearance; Consensus Document. APNM 36(S1>:S266-s298,20l1.
3.Chisholm DM, Collis ML, Kulak LL, DavenportW, and Gruber N. Physical activity readiness. British Columbia Medical Journal. 1975;17:375-378.
4.Thomas S, Reading J, and Shephard RJ. Revision of the Physical Activity Rea din ess Questionnaire (PAR-C&. Canadian Journal of Sport Science 1992;17:4 338-345.
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01 -11-2020
Filling out the Activity PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) is a crucial step to ensure your safety and health as you embark on or change your physical activity regimen. This form is designed to identify individuals who may need further evaluation by a health care provider before they increase their physical activity levels. The following step-by-step guide will walk you through how to properly complete the form.
After completing the PAR-Q+, it's advisable to keep a copy for your records and bring it along when consulting with a health care provider or qualified exercise professional, especially if you’ve answered "YES" to any question. This will help them provide you with tailored advice and ensure your physical activities are safe and beneficial for your health condition. Remember, engaging in physical activity is a vital part of maintaining a healthy lifestyle, but it's essential to do so in a way that respects your current health status and any medical conditions you might have.
The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) is a tool used to identify individuals who should seek medical advice before starting or increasing their physical activity levels. It helps to ensure that physical activity is safe and beneficial for them.
Anyone planning to become more physically active should complete the PAR-Q+ form. It is especially important for those who are not used to regular vigorous exercise, over the age of 45, or have health concerns.
The questionnaire should be filled out at least once every 12 months or sooner if your health condition changes. This helps to ensure that the guidance it provides remains accurate and relevant to your current health status.
If you answer "YES" to any of the questions, it is recommended that you seek further advice from your doctor or a qualified exercise professional before becoming more physically active. This is to make sure that any physical activity you undertake is safe for your condition.
Yes, if you answered "NO" to all the questions, you are generally cleared to become physically active. It is advised to start slowly and increase the intensity and duration of your activities gradually, following global physical activity guidelines suitable for your age.
If your health condition changes after you have completed the form, you should answer the questions on the form again and/or consult with a healthcare professional before continuing with your physical activity program.
Yes, individuals with underlying medical conditions or those who answer "YES" to specific questions will be guided to complete additional sections of the form or to consult with a physician or qualified exercise professional for a more personalized assessment.
Individuals who are under the legal age of consent or require the assent of a care provider must have the PAR-Q+ form signed by a parent, guardian, or care provider, acknowledging their understanding and consent to the participation in physical activity.
Any personal information and health data provided in the PAR-Q+ form should be treated with confidentiality, complying with applicable privacy laws. The entity collecting the form is responsible for ensuring it is stored securely and only accessed by authorized individuals.
For more information or if you have any further questions, you can contact a qualified exercise professional or visit the official website provided at the end of the PAR-Q+ document. Additionally, your healthcare provider may offer guidance and resources regarding safe physical activity practices.
Filling out the Activity Parq form requires attention to detail. Unfortunately, people often make mistakes in this process. Here are the most common errors:
It's essential to approach the Activity Parq form with care and honesty. Taking the time to accurately reflect on one’s health ensures safety when starting or modifying a physical activity routine.
When individuals are preparing to increase their physical activity levels, ensuring they are medically and physically ready is crucial. The Activity PAR-Q form plays a significant part in this process, helping to identify any health concerns that may require further medical advice before proceeding. Alongside this form, there are several other documents and forms that are often used to ensure a comprehensive health evaluation. Each serves a specific purpose, complementing the Activity PAR-Q to provide a well-rounded view of an individual's readiness for physical activity.
Together, these documents offer a comprehensive framework for safely increasing physical activity. By systematically assessing health status, obtaining informed consent, evaluating fitness levels, and being prepared for emergencies, individuals and professionals can navigate the path toward increased physical activity with confidence and care.
The Medical History Form is similar to the Activity Parq form as both collect information on one's past and existing health conditions to identify any potential risks before undergoing activities that could impact their health. Medical History Forms are typically used in healthcare settings to get a comprehensive understanding of a patient's health background.
A Consent Form for Exercise or Physical Activity also bears resemblance as it often includes questions regarding one’s readiness for physical exertion, similar to the Activity Parq’s purpose of ensuring that individuals are safe to engage in physical activity. This type of consent form might be used in gyms, health clubs, or before participation in a fitness program.
The Pre-Participation Physical Evaluation form, used mainly in the context of sports, examines whether individuals are medically and physically fit to partake in sports or related activities. It covers health history and physical examinations, akin to the Activity Parq, which seeks to uncover any health concerns that could be aggravated by physical activity.
A Workplace Health and Safety Assessment shares similarities, as it evaluates the suitability of an employee’s health for specific job duties, especially in physically demanding roles. Like the Activity Parq, it aims to identify any health limitations that could affect one’s ability to safely perform their job.
The Risk Assessment for Physical Education Class in schools, which ensures that students are capable of safely participating in physical education activities, is similar. It involves screening students for any health issues that could be exacerbated by physical activity, reflecting the Activity Parq’s preventive approach.
Lastly, the Health Screening Questionnaire for Volunteering, often required by organizations prior to engaging in volunteer activities, particularly those involving physical labor, represents another analogous document. It serves to identify health limitations or needs, ensuring volunteer activities are aligned with the individual’s physical capabilities.
When filling out the Activity PAR-Q form, it is essential to approach the task with thoroughness and honesty. Below are five key dos and don'ts to guide you through the process.
Do:
Don't:
There are several common misconceptions about the Activity PAR-Q (Physical Activity Readiness Questionnaire) form that need to be clarified to ensure that individuals understand its purpose and requirements fully.
Misconception 1: The PAR-Q form is only for older adults or those with severe health issues.
Contrary to this belief, the PAR-Q form is designed for everyone considering starting a new physical activity regimen, regardless of age or health status. It helps to identify any potential risks associated with increased physical activity for all individuals.
Misconception 2: Completing the PAR-Q+ means you’re automatically cleared for all types of physical activities.
While the PAR-Q form serves as a preliminary screening tool, it does not provide a comprehensive clearance for physical activities. Depending on your answers, you may need to consult with a doctor or qualified exercise professional for a more thorough evaluation and personalized advice.
Misconception 3: If you're under 45 and generally healthy, you don’t need to complete the PAR-Q form.
Even if you are under 45 and perceive yourself as healthy, filling out the PAR-Q form can uncover potential risks that aren’t immediately obvious. It encourages all individuals to assess their health status in relation to physical activity.
Misconception 4: Answering 'Yes' to questions on the PAR-Q form means you cannot participate in physical activities.
Actually, answering 'Yes' to any question indicates that you should seek further advice before becoming more active, not that you should avoid physical activity altogether. A doctor or qualified exercise professional can help you determine safe ways to incorporate exercise into your life.
Understanding these key points ensures that individuals approach their health and fitness activities with the right information and precautions, promoting safety and well-being in their physical activity choices.
The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) serves a crucial role in ensuring the safety of individuals looking to increase their levels of physical activity. The information derived from this questionnaire aims to identify the presence of health conditions that may require medical advice before engaging in physical activity. The following are key takeaways to remember when filling out and utilizing the Activity PAR-Q form.
Ultimately, the PAR-Q+ is a critical tool in promoting safe physical activity engagement. It emphasizes the need for a precautionary assessment to identify and mitigate potential health risks, thereby fostering a safer environment for physical exercise. Legal guardians, healthcare professionals, and fitness experts play key roles in interpreting the results of this questionnaire to inform appropriate and safe physical activity recommendations.
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