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Physical Activity Readiness Questionnaire

WeStryv PARQ

Your Details

Emergency Contact Details

Medical Details

Has your doctor ever said you have a heart condition and that you should only do physical exercise recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
Do you lose balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

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.


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.

Thanks for submitting!

If required, one of our team will be in touch shortly

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