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Pre-Screening (PAR-Q)

Form for Bootcamp

Please fill out this form if you are attending one of my Bootcamp sessions.

  • 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. If you are planning to become much more physically active than you are now, start by answering the seven questions below. If you are between the ages of 15 and 69, this form (PARQ) will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.
  • If you answered YES to one or more questions: Please talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which 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 about the kinds of activities you wish to participate in and follow his/her advice. Find out which community programs are safe and helpful for you. If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can: Start becoming much more physically active—begin slowly and build up gradually. This is the safest and easiest way to go. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active. Delay becoming much more active: If you are not feeling well because of a temporary illness such as a cold or a fever—wait until you feel better; or If you are or may be pregnant—talk to your doctor before you start becoming more active. Please note: If your health changes so that you then answer YES to any of the above questions, please tell us immediately. Ask whether you should change your physical activity plan.

  • Female Clients Only

  • Consent

    Note: 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 seven questions.
    I regularly send out an email newsletter with tips, and information about women’s health and fitness. Please confirm if you would like to receive this by email.
  • Please tick to confirm that you agree to our privacy policy regarding how we use your information.

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