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.

Prior to commencing a training programme with Blue Ocean Fitness you will be required to complete a Physical Activity Readiness Questionnaire (PAR-Q). This will gather information on your current and previous activity levels, your general standard of fitness and will inform us of your medical history.

The first part of this questionnaire explores your reasons for wanting to improve your health and provides you with the opportunity to tell us your likes and dislikes, your goals and your needs.

The Medical Questionnaire section of the PAR-Q will tell you if you should check with your doctor before you start a new fitness programme.

If you answer ‘yes’ to any of the questions related to your Medical History, or are over 69 years of age and you are not used to being very active, check with your doctor before embarking on any new fitness activity.

Please read the questions carefully and answer each one honestly.

Click here to download and print off a full copy of the Blue Ocean Fitness PAR-Q Physical Activity Readiness Questionnaire to complete before your first consultation.

You cannot begin a training programme or participate in our sessions without it. 

 

Your Health Goals:

 

What health goals would you like to achieve in the next 3 months?

 

 

________________________________________________________________

 

Name 3 things you could do to improve your health?

 

  

What are your main reasons for starting a fitness programme? (Tick all that apply):

 

General Conditioning        ___                             Muscular Strength             ___

 

Weight/Fat Loss                 ___                             Aerobic Fitness                   ___

 

Stress Management          ___                             Flexibility                              ___

 

Appearance                         ___                             Improve Self Esteem         ___

 

Other (please state:)

 

 

 

How would you describe your general health and fitness?

 

 ________________________________________________________________

                       

________________________________________________________________

 

 

Have you ever done any structured exercise? (Please circle):                YES / NO

 

If ‘Yes’ what did you do? ___________________________________________

 

 

What type of exercise do you enjoy the most?

 

 

________________________________________________________________

 

 

What type of exercise do you least enjoy?

 

 

 

 

What are the main barriers preventing you from exercising?

 

Lack of facilities      ____               No Motivation        ____               No Time        __

 

Injury/Illness           ____               Unfit                          ____               Family            __

 

Lack of Knowledge____               Appearance             ____               Work              __

 

Other _________________________________________________________

 

 

Diet and Nutrition:

 

On a scale of 1-10 (1 = poor, 10 = excellent), how would you assess the quality of your eating habits?             _________________________________

 

Would you like any help or advice in changing the quality of your eating habits? (Please circle)                                                                           YES / NO

 

Do you follow any particular diet or eating patterns? Please provide more information: __________________________________________________

 

Lifestyle:

Do you drink alcohol?                               YES / NO

If ‘Yes’, how much per week?  ______________________________________

(Click here to use Alcohol Change UK’s unit calculator)

 

Do you smoke?                                           YES / NO

If ‘Yes’, how much per week? ______________________________________

 

 

Medical History:

  1. Has your doctor ever said that you have a heart condition and that you should only do physical activity when recommended by a doctor?

 

YES / NO

 

  1. Do you feel pain in your chest when you do physical activity?

 

YES / NO

 

  1. In the past month, have you had a chest pain when you were not doing physical activity?

 

YES / NO

 

  1. Do you lose balance because of dizziness or do you ever lose consciousness?

 

YES / NO

 

  1. Do you have a bone or joint problem that could be made worse by a change in your physical activity?

 

YES / NO

 

  1. Is your doctor currently prescribing you drugs for your blood pressure or heart?

 

YES / NO

 

  1. Do you know any other reason why you should not do physical activity?

 

YES / NO

 

If you answer YES to one or more medical questions, talk with your doctor before you commence. Tell your doctor about your PAR-Q and the questions you answered YES.

  • You may be able to do any activity you want as long as you start slowly and build up gradually. Or you may need to restrict your activities to those that are safe for you. Talk with your doctor and follow his/her advice, providing us with written permission to continue if necessary.

 

If you answer NO to all questions you can be reasonably sure that you can:

  • Start slowly and build up gradually. This is the safest and easiest way to go.
  • Take part in a fitness assessment. This is an excellent way to determine your basic fitness level so that you can plan the best way for you to live actively.

 

Please Note:

If your health changes so that you then answer YES to any of the above questions, let your health professional know immediately.

 

Informed Use of the PAR-Q:

Blue Ocean Fitness and its agents assume no liability for persons who undertake physical activity. If in doubt after completing this questionnaire, consult your doctor prior to physical activity.

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

 

Client Print Name: ______________________________________________

Client Signature: ________________________________________________

Date: _________________________________________________________

 

Instructor Print Name:___________________________________________

Instructor Signature: _____________________________________________

Date: _________________________________________________________

 

Click here to download and print off a full copy of the Blue Ocean Fitness PAR-Q Physical Activity Readiness Questionnaire to complete before your first consultation.