Safety of Exercise Participation

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People of any age who are not at high risk for serious health problems can safely exercise at a moderate intensity (60% or less of maximum heart rate) without a prior medical evaluation. Likewise, if you are male and under 40 or female and under 50 and in good health, exercise is probably safe for you. If you are over these ages or have health problem, especially high blood pressure, heart disease, muscle or joint problems, or obesity, see your physician before starting a vigorous exercise program. The Canadian Society for Exercise Physiology has developed the Physical Activity Readiness Questionnaire (PAR-Q) to help determine exercise safety; this questionnaire appears on the next page.

To further assess the safety of exercise for you, complete as much of the following health profile as possible. If the PAR-Q or anything on the general health profile indicate that you should see your-physician before beginning an exercise program, or if you have any questions about the safety of exercise for you, make an appointment to talk with your health care provider to address your concerns.

General Health Profile for Exercise Safety
General Information

Age:	Total cholesterol:	Blood pressure: /
Height:	HDL:	Triglycerides:
Weight:	LDL:	Blood glucose:

Are you currently trying to gain or lose weight? (check one if appropriate)

Medical Conditions/Treatments
Check any of the following that apply to you and add any other conditions that might affect Your ability to exercise safely.

	heart disease
	lung disease
	diabetes
	allergies
	asthma
	depression, anxiety, or another psychological disorder
	eating disorder
	back pain
	arthritis
	other injury or joint problem:
	substance abuse problem
	other:
	other:
	other:
	Do you have a family history of cardiovascular disease (a parent, sibling, or child who had a heart attack or stroke before age 55 for men or 65 for women)

List any medications or supplements you are taking or any medical treatments you are undergoing. Include the name of the substance or treatment and its purpose. Include both prescription and over-the-counter drugs and supplements.

Lifestyle Information
Check any of the following that is true for you, and fill in the requested information.

	I usually eat high-fat foods (fatty meats, cheese, fried foods, butter, full-fat dairy Products) every day.
	I consume fewer than 5 servings of fruits and vegetables on most days.
	I smoke cigarettes or use other tobacco products, or I am regularly exposed to ETS, If true, describe use/exposure:
	I regularly drink alcohol. If true, describe consumption pattern:
	I often feel as if I need more sleep. (I need about hours per day; I get about hours per day)
	I feel as though stress has adversely affected my level of wellness during the past year.

Describe your current activity pattern. What types of moderate and vigorous activity to you engage in on a daily or weekly basis?

PAR-Q & YOU

(A Questionnaire for People Aged 15 to 69)

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 in the box below. If you are between the ages of 15 and 69, the PAR-Q 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.

YES	NO
		1.	Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
		2.	Do you feel pain in your chest when you do physical activity?
		3.	In the past month, have you had chest pain when you were not doing physical activity?
		4.	Do you lose your balance because of dizziness or do you ever lose consciousness?
		5.	Do you have a bone or joint problem that could be made worse by a change in your physical activity?
		6.	Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
		7.	Do you know of any other reason why you should not do physical activity?

If you answered

YES to one or more questions

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 which 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

NO to all questions

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.
take part in a fitness appraisal—this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

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, tell your fitness or health professional. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

You are encouraged to copy the PAR-Q but only if you use the entire form

Note, If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may be used for legal or administrative purposes.
I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

NAME
SIGNATURE		DATE
SIGNATURE OF PARENT or GUARDIAN (for participants under the age of majority)		WITNESS
© Canadian Society for Exercise Physiology Société canadienne de physiologie de l'exercice	Supported by	Health Canada	Santé Canada

Reprinted from the 1994 revised version of the Physical Activity Readiness Questionnaire (PAR-Q and YOU). The PAR-Q and YOU is a copyrighted, pre-exercise screen owned by the Canadian Society for Exercise Physiology