Physical Activity Readiness Questionnaire
Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?
Yes
No
Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?
Yes
No
Do you ever feel faint, dizzy or lose balance during physical activity/exercise?
Yes
No
Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
Yes
No
If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months?
Yes
No
Do you have any other conditions that may require special consideration for you to exercise?
Yes
No
If you have answered yes to any of the above, we recommend you seek medical advice before taking part in any exercise and that by entering the facility you do so at your own risk. We may also require a copy of medical clearance for certain types of exercise.
Submit