Regular physical activity is fun and healthy and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active. If you are planning to become much more physically active than you are now, start by answering the seven questions below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: circle YES or NO.
IF YOU ANSWERED YES to one or more questions… Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.
DELAY BECOMING MUCH MORE ACTIVE…
IF YOU ANSWERED NO TO ALL QUESTIONS… If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:
Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.
NOTE: If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may be used for legal or administrative purposes.
“I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.”
NAME:
SIGNATURE:
DATE:
SIGNATURE OF PARENT:
Or GUARDIAN (for participants under the age of majority)
WITNESS:
NOTE: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the seven questions.