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Polytechnic University of The Philippines

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Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES


Santa Rosa Campus
____________________________________________________________

PAR-Q and YOU Questionnaire (prior to the activity test)

Name: TULLER, KYLA FAYE R. Date: MAY 14, 2022


Year/Section: BSED-EN 2-2_________________

Physical Activity Readiness


Questionnaire- PAR-Q
(revised 2002)
PAR-Q & YOU
A Questionnaire for People Aged 15-69

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 physical active.

If you are planning to become much more physical 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 question
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 have lose your balance because of dizziness or do you ever
lose consciousness? /
5. Do you have a bone or joint problem (for example, back, knee, or hip)
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? /

__________KYLA FAYE R. TULLER__________


Signature over printed name

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