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PAR-Q (Health Screening Form) - Coggle Diagram
PAR-Q (Health Screening Form)
Personal Information section
Full name
Address
Date of birth
Contact details
Email
Mobile number
Home number
Next of kin- someone that the instructor can contact in case something goes wrong
GP name and address
Medical History, family medical history and injuries
include at least 10 questions
should ask questions about health and include information on injuries
Consider:
What the injury was
How long ago it was
Did they have surgery or not
How long they were out of the sport for
Physical activity levels
How long have they been participating in the sport for?
What sports do they normally compete in?
Are they competitive in their sport?
If so, what level are they currently at?
What are their training goals in their sport?
At least 3
They should be SMART
Specific- what are they looking to achieve, why they want to achieve it and how they are going to achieve it.
Measurable- they must establish how they are going to measure their progress in achieving their goal.
Attainable- they have to have the skill set available to attain the goal
Realistic- it needs to be within reach of the performer's current skill set and fitness levels
Time-bound- A deadline needs to be set
Lifestyle factors
Smoking
How long have they smoke for?
How often do you smoke?
Alcohol
How often do you consume alcohol?
How many units per week?
Diet
Do they have a balanced diet?
What does their weekly diet typically consist of?
Declaration
A paragraph at the end of the form
Outline all data that will remain confidential and that if they wish to, they can take or destroy any data at any time
Get the client to sign and date to state that all information given is truthful and correct
It also needs to be signed by the person giving out the form