Apply now - NTU Sports Analysis and Performance

Do you have a bone or joint problem such as arthritis, which has been aggravated by exercise or might be made worse with exercise?*

Yes
No

To your knowledge, do you have high blood pressure?*

Yes
No

To your knowledge, do you have low blood pressure?*

Yes
No

Do you have Diabetes mellitus or any other metabolic disorder?*

Yes
No

To your knowledge, do you have raised cholesterol (serum level above 6.2mmol/L)?*

Yes
No

Do you have or ever suffered a heart condition?*

Yes
No

Have you ever felt pain in your chest when you do physical exercise?*

Yes
No

Is your doctor currently prescribing you drugs or medication?*

Yes
No

Have you ever suffered from shortness of breath at rest or with mild exercise?*

Yes
No

Is there any history of Coronary Heart Disease within your family?*

Yes
No

Do you ever feel faint, have spells of dizziness or have ever lost consciousness?*

Yes
No

Do you currently drink more than the average amount of alcohol per week?*

**14 units for men and women (1 unit = 1⁄2 pint of beer/cider or 1 small glass of wine)**

Yes
No

Do you currently smoke?*

Yes
No

You do NOT currently exercise regularly (at least 3 times per week) and/or work in a job that is physically demanding.*

Agree
Disagree

Are you, or is there any possibility that you might be pregnant?*

Yes
No

Do you know of any other reason why you should not participate in a programme of physical activity?*

Yes
No

If you answered YES to one or more questions please give details:*

If you answered yes to one or more questions:

If you have not already done so, consult with your doctor by telephone or in person before increasing your physical activity and/ or taking a fitness appraisal. Inform your doctor of the questions that you answered ‘yes’ to on the PAR-Q or present your PAR-Q copy. After medical evaluation, seek advice from your doctor as to your suitability for:

Unrestricted physical activity starting off easily and progressing gradually, and ...
Restricted or supervised activity to meet your specific needs, at least on an initial basis.

If you answered NO to all questions:

If you answered the PAR-Q honestly and accurately, you have reasonable assurance of your present suitability for:

A graduated exercise programme
A fitness appraisal.

Assumption of Risk*

 I hereby state that I have read, understood and answered honestly the questions above. I also state that I wish to participate in activities, which may include aerobic exercise, resistance exercise and stretching. I realise that my participation in these activities involve the risk of injury and even the possibility of death. I hereby confirm that I am voluntarily engaging in an acceptable level of exercise, which has been recommended to me.

Client's first name*

Client's last name*

Select your age range*

Email Address*

Name

This field is for validation purposes and should be left unchanged.

Start your application

Please complete this brief questionnaire to confirm fitness to participate:

If you answered yes to one or more questions:

If you answered NO to all questions: