PAR Q

PRE-EXERCISE SCREENING & INFORMED CONSENT

This PAR-Q form will tell you and us if you should check with your doctor before you start exercising. If you are over 69 years of age, and you are not used to being very active, check with your doctor first

Intershape Studios PARQ

PRE-EXERCISE SCREENING & INFORMED CONSENT PAR-Q

To register to our fitness studio please fill out the following medical form

First Name

Email Address

Last Name

Date of Birth

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes

I declare that the info I’ve provided is accurate & complete

In Compliance with the GDPR (Data protection May 2018) law by signing below, you are giving us authorization to hold your details, which are required between, yourself and us, Intershape studio Your details are kept for lawful purposes and not shared with any third party.

Initials

Today's Date

Thanks for submitting!

If you are or may be pregnant - talk to your doctor before you start becoming more active.

Note: Please inform your fitness or health professional if your health changes with reference to the above.

If you have answered YES to one or more questions talk with your doctor BEFORE you start exercising.

You may still be able to do classes you want - as long as you start slowly and build up gradually. Or, you may need to restrict your classes to those, which are safe for you. Talk with your doctor about the kinds of classes you wish to participate in and follow his/her advice.

If you answered NO to all questions:

Start becoming much more physically active NOW! - Begin slowly and build up gradually.