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About the Programme
Services
Physiology tests
Biomechanical tests
Workshops
Contact us
Apply now
About the Programme
Services
Physiology tests
Biomechanical tests
Workshops
Contact us
Apply now
Continue your application
Thank you for completing the PAR-Q form, prior to being accepted on to the programme please complete this brief questionnaire to confirm fitness to participate:
First Name
*
Last Name
*
Email address
*
Date of birth
*
DD slash MM slash YYYY
Please complete this brief questionnaire to confirm fitness to participate:
1. At present, do you have any health problem for which you are:
(a) on medication, prescribed or otherwise
*
Yes
No
(b) attending your general practitioner
*
Yes
No
(c) on a hospital waiting list
*
Yes
No
2. In the past two years, have you had any illness which has required you to consult your GP?
*
Yes
No
Do you wish to confirm the problem was/is short-lived, insignificant or well controlled?
*
Yes
No
Please provide a description of the circumstances here:
*
3. In the past two years, have you had any illness which require you to:
(a) attend a hospital outpatient department
*
Yes
No
(b) be admitted to hospital
*
Yes
No
4. Have you ever had any of the following?
(a) Convulsions/epilepsy
*
Yes
No
(b) Asthma
*
Yes
No
(c) Eczema
*
Yes
No
(d) Diabetes
*
Yes
No
(e) A blood disorder
*
Yes
No
(f) Head injury
*
Yes
No
(g) Digestive problems
*
Yes
No
(h) Heart problems
*
Yes
No
(i) Problems with bones or joints
*
Yes
No
(j) Disturbance of balance/coordination
*
Yes
No
(k) Numbness in hands or feet
*
Yes
No
(l) Disturbance of vision
*
Yes
No
(m) Ear/hearing problems
*
Yes
No
(n) Thyroid problems
*
Yes
No
(o) Kidney or liver problems
*
Yes
No
(p) Allergy to nuts, alcohol etc.
*
Yes
No
(q) Any problems affecting your nose e.g. recurrent nose bleeds
*
Yes
No
(r) Any nasal fracture or deviated nasal septum
*
Yes
No
5. Has any, otherwise healthy, member of your family under the age of 50 died suddenly during or soon after exercise?
*
Yes
No
6. Are there any reasons why blood sampling may be difficult?
*
Yes
No
7. Have you had a blood sample taken previously?
*
Yes
No
8. Have you had a cold, flu or any flu like symptoms in the last month?
*
Yes
No
9. Are you pregnant, trying to become pregnant or breastfeeding?
*
Yes
No
N/A
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Comments
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