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Par Q Forms for Personal Trainers

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Par Q Forms you can download for your personal trainer business. These forms are also known as Physical Activity Readiness Questionnaires.

Par Q's help you determine if your client is ready for a physical fitness program. It's important to ask your clients to fill out at least one par q form before starting any program.

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Par Q Forms for Personal Trainers

  1. 1. Par Q Form Name: __________________________________ Date: _______________________________ Telephone: ______________________________ Date of Birth:_______ Age: _________ Height: _____________ Weight:________ In Case of Emergency Contact: ____________________________ Relationship:___________ Address: ____________________________ Phone: _______ Physician: ____________________________ Specialty: _______ Address: _______ Phone: _______ Are you currently under a doctor’s care: Yes No If yes, explain: ____________________________ When was the last time you had a physical examination? ____________________________ Have you ever had an exercise stress test: Yes No Don’t Know If yes, were the results: Normal Abnormal Do you take any medications on a regular basis? Yes No If yes, please list medications and reasons for taking: ____________________________ Have you been recently hospitalized? Yes No If yes, explain: ____________________________ Do you smoke? Yes No Are you pregnant? Yes No Do you drink alcohol more than three times/week? Yes No Is your stress level high? Yes No Are you moderately active on most days of the week? Yes No Do you have: High blood pressure? Yes No High cholesterol? Yes No Diabetes? Yes No Have parents or siblings who, prior to age 55 had: Yes No A heart attack? Yes No A stroke? Yes No High blood pressure? Yes No
  2. 2. High cholesterol? Yes No Known heart disease? Yes No Rheumatic heart disease? Yes No A heart murmur? Yes No Chest pain with exertion? Yes No Irregular heart beat or palpitations? Yes No Lightheadedness or do you faint? Yes No Unusual shortness of breath? Yes No Cramping pains in legs or feet? Yes No Emphysema? Yes No Other metabolic disorders (thyroid, kidney, etc.)? Yes No Epilepsy? Yes No Asthma? Yes No Back pain: upper, middle, lower? Yes No Other joint pain (explain on back of form)? Yes No Muscle pain or an injury (explain on back of Form)? Yes No To the best of my knowledge, the above information is true. Signature ____________________________ Date____________________________ Witness ____________________________
  3. 3. CLICK HERE TO ACCESS MORE PERSONAL TRAINER FORMS

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