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1. Has your doctor ever said that you have bone or joint problems, such as arthritis, that has been aggravated by exercise or might be made worse by exercise?
Yes
No
2. Do you have high blood pressure?
Yes
No
3. Do you have low blood pressure?
Yes
No
4. Do you have Diabetes Mellitus or any other metabolic disease?
Yes
No
5. Has your doctor ever said you have raised cholesterol (serum level above 6.2mmol/L)?
Yes
No
6. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Yes
No
7. Have you ever felt pain in your chest when you do physical exercise?
Yes
No
8. Is your doctor currently prescribing you any drugs or medication?
Yes
No
9. Have you ever suffered from unusual shortness of breath at rest or with mild exertion?
Yes
No
10. Is there any history of Coronary Heart Disease in your family?
Yes
No
11. Do you often feel faint, have spells of severe dizziness or have lost consciousness?
Yes
No
12. Do you currently drink more than the average amount of alcohol per week (21 units for men and 14 for women)?
Yes
No
13. Do you currently smoke?
Yes
No
14. Do you currently exercise less than 3 times per week?
Yes
No
15. Are you, or is there any possibility that you might be pregnant?
Yes
No
16. Do you know of any other reason why you should not participate in a programme of physical activity?
Yes
No

PHYSICAL READINESS ACTIVITY QUESTIONNAIRE (PAR-Q)

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