Post-Natal PAR-Q

    The following questionnaire asks you questions about your current and previous health including medical conditions, injuries and medication (Health Data). We collect your Health Data from you so that we can safely provide you with our services including adjusting recommendations to minimise risk to you (Purpose). We may share your personal data (including Health Data) with processors for this purpose, as set out in our Privacy Policy. By ticking the below box, completing the following questionnaire, or providing us with your Health Data you consent to our collection and use of your Health Data for the Purpose. I confirm that I have read and understood the above information and consent to the collection and use of my Health Data for the stated Purpose.

    Participant Information:

    Emergency Contact / Parent / Guardian Details:

    Goals:

    General Health and Medical Clearance Questions:


    - Has your doctor advised that you should not participate in physical activity or exercise?


    - Do you have a heart condition, or have you ever experienced chest pain when engaging in physical activity?
    - Do you feel pain in your chest when you perform 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 any bone or joint problems that could be made worse by a change in your physical activity?


    - Are you currently taking any medication for a chronic condition that might affect your ability to exercise safely?


    - Have you ever been diagnosed with high blood pressure or elevated cholesterol levels?
    - Are you currently taking any medication to manage these conditions?


    - Do you have any chronic medical conditions (e.g., diabetes, asthma, epilepsy) that might require special consideration during physical activity?


    - Have you had surgery in the past year that may affect your ability to exercise?


    - Do you experience unexplained fatigue, shortness of breath, or dizziness with mild exertion?


    - Are there any other physical or medical conditions that should be considered before starting an exercise program?


    - If you answered "Yes" to any of the above questions, please provide more information:

    Post-Natal Health and Medical Clearance Questions:











    Activity Levels:






    Well-being:



    A: Previously physically active and there are no apparent complications in this pregnancy.
    B: Previously physically inactive and there are no apparent complications in this pregnancy.
    C: Disclosed information that will require a further medical referral prior to receiving pre and post-natal exercise, advice and guidance.

    Personal Health Declaration and Acknowledgement

    I confirm that all information provided in this questionnaire is accurate and a true reflection of my current health and circumstances.
    I understand it is my responsibility to update the PAR-Q form if any changes occur in my health or circumstances.
    I acknowledge that I am participating in this fitness programme voluntarily and at my own risk.
    The information collected in this questionnaire will be stored and treated in line with GDPR. The information will only be shared with instructors that are directly associated with the client’s exercise prescription.