PAR-Q Form Name * First Name Last Name Date of Birth * MM DD YYYY Gender * Male Female Other Height (Feet and inches) * Weight (kg) * Do you have any dietary requirements? (e.g., Vegan, Vegetarian, Allergies etc). If so, please details below. * Health Do you have any injuries, current or previous, that we should be aware of? If so, please details below. * Do you have any health conditions that we should be aware of? If so, please provide details below. * Are you on any recurring medication? If so, please provide details below. * How would you rate your current stress level on a scale from 1 to 10? (1 being not stressed at all and 10 being extremely stressed) * 1 2 3 4 5 6 7 8 9 10 Do you consider yourself to sleep well? * Yes No Fitness How would you rate your current fitness level on a scale from 1 to 10? (1 being not fit and 10 being very fit) * 1 2 3 4 5 6 7 8 9 10 Please let us know about your goal/goals. (E.G Weight loss/Fitness level/Body Aesthetic) * Have you been at your desired goal previously? If so, when? * Current routine Are you a morning or night person? * Describe your current health and fitness routine. (if applicable) * On workdays, what time do you wake up and go to bed? * On non-workdays, what time do you wake up and go to bed? * Is there a time of the day when you are often feeling fatigue? If so, how do you combat it? * How long after you wake up do you usually eat? And what would you typically eat/drink? * Are your meals regular? And generally at the same time each day? If not, please describe. * How late in the day is your last intake of food? Please give an example of what the food might typically be. * How late in the day is your last intake of drinks? Please give an example of what the drink might typically be. * How often do you snack during a day and what kind of snacks would you usually choose? * Do you take any supplements? If so, please specify. * In a few words, please describe what you think is currently holding you back from achieving your health and fitness goals. * Thank you!
