WJEC/Eduqas GCSE PE Personal Fitness Programme: Student Companion

3 Self-analysis centre (a blank PAR-Q form can be found in Appendix 4. p. 112). This could be completed at the start of your PFP prior to any engagement in physical activity. The PAR-Q will not form part of the assessment, but it is an opportunity to: • provide the reader of your PFP with some background information • use as evidence, if the intensity of your training programme needs to be adapted for any health reasons • apply theory . Figure 3.1 A PAR-Q form PAR-Q Physical Activity Readiness Questionnaire Objective A Physical Activity Readiness Questionnaire or PAR–Q is a method of uncovering health and lifestyle issues prior to taking part in an exercise programme. Personal details Name: _________________________________________________________________ D.O.B: _____________ Age: __________ Height: ___________ Weight: ___________ Emergency contact number: ______________________________________________ Emergency contact name: ________________________________________________ Relationship of contact: ___________________________________________________ Your address: ___________________________________________________________ ________________________________________________________________________ Contact number: ________________________________________________________ Guidance Please answer all questions as accurately as possible. Do you smoke? Are you pregnant? Do you drink alcohol more than three times a week? Do you have: History of heart problems, chest pains? High blood pressure? History of breathing or lung problems? Increased blood cholesterol? Describe any regular physical activity you take part in: __________________________________________________ __________________________________________________ __________________________________________________ NAME: All the information is true to the best of my knowledge. SIGNATURE: YES YES YES YES YES NO NO NO NO NO YES NO Questions Are you currently under a doctor’s care? If YES explain: ______________________________________________________________________________________________ When was the last time you had a physical examination? _________________________________________________________ Do you take any medication on a regular basis? If YES, please list medications and reasons for taking: ___________________________________________________________ ___________________________________________________________________________________________________________ Have you recently been hospitalised? If YES explain: ______________________________________________________________________________________________ YES YES NO NO PFP YES NO YES NO 26