PFN Athletics – Physical Activity Readiness Questionnaire (PAR-Q)
Participant Name: {name}
Date of Birth: {dob}
Parent/Guardian Name (if under 18):
This questionnaire is designed to identify medical conditions or risk factors that may require consultation with a healthcare provider before beginning or continuing physical activity at PFN Athletics.
Please answer the following questions honestly and completely:
General Health
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Has a doctor ever said you have a heart condition, high blood pressure, or any cardiovascular disease?
Yes No
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Do you ever experience chest pain, dizziness, or fainting during physical activity?
Yes No
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Do you have a respiratory condition (such as asthma, COPD, or other breathing issues)?
Yes No
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Do you have diabetes, metabolic disease, or any other chronic medical condition?
Yes No
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Are you currently taking any prescribed medications that may affect exercise performance?
Yes No
Musculoskeletal & Injury History
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Do you have any bone, joint, or muscle problems (such as back, knee, or shoulder pain) that could worsen with physical activity?
Yes No
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Have you had any recent injuries, surgeries, or been advised not to participate in physical activity?
Yes No
Other Considerations
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Is there any reason not mentioned above why you should not participate in physical activity?
Yes No
If you answered “Yes” to any question:
We recommend consulting with your physician before participating in PFN Athletics training programs. Please provide details below:
Notes / Details:
Acknowledgment
I have answered this questionnaire truthfully and to the best of my knowledge. I understand that it is my responsibility to inform PFN Athletics staff of any changes in my health status.
PFN Athletics