Physical Activity Readiness Questionnaire

Regular physical activity is fun and healthy. Through regular physical activity we can improve the function of our heart, lungs, muscles, joints and mental health. We can also decrease our risk of morbid diseases and conditions as well as improving the way we look and feel.

Its important to know that exercise can carry small risks to certain groups of people, and the purpose of this questionnaire is to determine if you are physically ready to begin a new training programme.

If you are aged 15 to 69 and have no pre existing medical conditions, this form will highlight if there is a need for you to consult with your doctor prior to starting exercise.

If any of the following apply to you, please consult with your doctor either in person or on the phone before you begin training:

Persons under the age of 15 with minimal exercise history

Persons with a existing medical condition

Persons taking any prescribed medication

Persons who are pregnant

Persons over the age of 69

Persons with a history of high/low blood pressure

In addition to the above, please answer the next set of questions honestly and if you are unsure, Consult with your doctor by phone or in person before you start becoming much more physically active or before you have a fitness test.

Make sure you tell your doctor about this form and any questions that you answered Yes to and obtain written medical clearance to begin exercising.

Name *
If answer yes, then please go into as much detail as possible regarding your pregnancy and delivery as well as any pregnancy related conditions or complications.