The RJ4All Rotherhithe Community Centre

+44(0)7708758600 Plough Way London SE16 2LJ, UK

PAR-Q FORM

PAR-Q FORM

Welcome to your PAR-Q FORM

Have you ever been advised by your doctor that you have a heart condition and should only do physical activity recommended by a doctor?

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

Have you ever had chest pain when you are not doing physical activity?

Do you ever feel faint or have spells of dizziness?

Do you have a bone or joint problem that could be made worse by exercise?

Have you ever been told you have high blood pressure?

Are you currently taking any medication?

Are you pregnant or have had a baby in the last 6 months?

Have you had a surgery recently?

Have you had COVID-19 in the last 6 months?

Is there any other reason why you should not participate in physical activity?

Are you under the age of 18 years?

Date of Birth

If you have ticked ‘YES’ to one or more questions It is mandatory you speak with your GP or Doctor either in person or over the phone if you can take part in physical activities. Explain to your doctor regarding the questions you answered ‘YES’ to and your doctor might issue you a letter to give to RJ4ALL. If you have ticked 'No' to all the questions You can take part in physical activities organised by RJ4ALL and remember to always start slowly.

Please note - If there are any changes with your health and this requires you changing some of your answers from ‘NO’ to ‘YES’, please consult with your GP or Doctor immediately and inform a staff member at RJ4ALL.
Please thick the following

Name

Surname

Date

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