Personal Training – Intro Call Request & PAR-Q

Medical Screening Questions

Please answer Yes or No to the following:

1. Has a doctor ever advised you that you have a heart condition or should only do exercise recommended by a doctor?

2. Do you experience chest pain when exercising?

3. In the past month, have you had chest pain when NOT doing physical activity?

4. Do you ever lose balance due to dizziness, or have you ever lost consciousness?

5. Do you have any bone, joint, or muscle problems that could be made worse by exercise?

6. Has a doctor prescribed medication for your blood pressure or a heart condition?

7. Do you have any other medical conditions (such as diabetes, epilepsy, asthma) that could affect your ability to exercise safely?

8. Are you currently pregnant or have you given birth in the last six months?

9. Have you had recent surgery or any injuries that may affect your ability to exercise?

10. Do you know of any other reason why you should not participate in physical activity?

IMPORTANT – PLEASE READ

• If you answered YES to any question, please provide further information during your consultation. Depending on your response, I may ask you to obtain medical clearance before commencing personal training.

• I am not a medical professional and do not provide medical advice or assessments.

• By participating, you accept full responsibility for your health and well-being.

Participant Declaration & Acknowledgement

I confirm that the information I have provided is accurate and complete to the best of my knowledge. I understand that participation in physical activity involves inherent risks and I accept responsibility for participating within my own abilities and following SilviaK Fitness's safety guidance.

I agree to inform SilviaK Fitness of any relevant changes to my health, medical conditions, injuries, pregnancy or medication that may affect my ability to exercise safely.

I understand that SilviaK Fitness is not responsible for injury, loss or damage arising from risks inherent in participation, except where liability cannot lawfully be excluded or limited.

Privacy

The information provided in this form, including health information, will be processed in accordance with the SilviaK Fitness Privacy Policy. By submitting this form, you confirm that you have read the Privacy Policy.