Antenatal PARQ
Your Details
Emergency Contact Details
Medical Details
YES to one or more questions:
You should consult with your doctor to clarify that it is safe for you to become physically active at this current time and in your current state of health.
NO to all questions:
It is reasonably safe for you to participate in physical activity, gradually building up from your current ability level. A fitness appraisal can help determine your ability levels.
PLEASE SIGN THE FIRST BOX (AND SECOND BOX IF APPLICABLE)
I have read, understood and accurately completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury.
Having answered YES to one or more of the medical questions above, I have sought medical advice and my GP has agreed that I may exercise.
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 6 questions. If there are any changes at all in your medical circumstances, please get in touch with me.
Postnatal Specific Questions
I have read, understood and accurately completed this questionnaire. I confirm that I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury.
Thanks for submitting!
If required, one of our team will be in touch shortly