Physical Activity Readiness Questionnaire (PAR-Q)

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PAR-Q

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PAR-Q

Physical Activity Readiness Questionnaire (PAR-Q)

“What the mind believes, the body achieves.”
— Napoleon Hill

This readiness questionnaire is designed to help ensure your wellness journey is safe, empowering, and aligned with your body’s needs. Please complete the form below as a prerequisite to joining Blair’s holistic fitness programs.

Full Name

Email Address

Date of Birth

Contact Number

Emergency Contact

Relationship

Have you ever been advised by a medical professional to avoid physical activity?

Yes No

Do you experience shortness of breath, chest pain, or dizziness during physical activity?

Yes No

Are you currently pregnant or recovering postpartum?

Yes No

Have you been diagnosed with any chronic conditions (e.g., arthritis, diabetes, heart disease) that may affect physical activity?

Yes No

Do you have any joint, muscle, or bone issues that could worsen with movement or exercise?

Yes No

Are you currently on any medications that might affect your performance or mobility?

Yes No

Do you experience significant stress, anxiety, or mental tension that impacts your focus during movement?

Yes No

Is there any additional information about your health that you believe Blair should know to better support you?

Yes No

If yes, please specify:

What are your primary goals? (Select all that apply)

Have you previously practiced yoga, strength training, or flexibility exercises?

Yes No

If yes, briefly describe your experience:

Are you interested in:

Terms & Conditions

By signing below, I confirm that I have answered the above questions truthfully and to the best of my knowledge. I understand that participation in physical activities involves risks and agree to inform Blair Harp of any changes in my health.

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Physical Activity Readiness Questionnaire (PAR-Q)

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