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Assessing Your Needs

All information received on this form will be treated as strictly confidential.  Please fill out the forms as accurately as possible.  This information is essential to develop a program that addresses your needs, goals and interests and that is safe, effective and fun.


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 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.

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 that 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.