Physical Activity Readiness Questionaire

Please tell me about how you are doing physically and any issues you are dealing with.

  • YesNo
    Have you tension, stiffness? List below
    Have you an injury or a condition that may affect your practice?
    Do you exercise/ move regularly? If so, list below
    Can you get down and up off the floor easily?
    Do you have asthma?
    Do you have diabetes?
    Do you have high blood pressure?
    Low blood pressure/fainting?
    Do you have back problems?
    Neck problems?
    Shoulder problems?
    Knee problems?
    Wrist problems?
    Have you ever experienced chest pains when exercising?
    Have you had any surgery in the last few years?
    Are you pregnant?
    Have you recently been pregnant?
  • Tell me about your experience and what level you are at:
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