OrchardWellness

Home
Classes
Membership
Community
Contact
Free Trial

Physical Activity
Readiness Questionnaire

Please complete this short health questionnaire before your first session. It helps us keep you safe and get the most from your training.

Why do we ask for this? The PAR-Q is a standard fitness industry health screen. It takes around 3–4 minutes to complete and helps your coach understand any conditions or considerations before you exercise. Your information is kept confidential and stored securely in line with our Privacy Policy.

Don't fill this in:

Your Details

First Name *

Last Name *

Date of Birth *

Gender

Email Address *

Phone Number *

Emergency Contact Name *

Emergency Contact Number *

Health Questions

Please answer all questions honestly. If you answer YES to any question, please provide details in the box below it.

1. Has a doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

No Yes

2. Do you feel pain in your chest when you do physical activity?

No Yes

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

No Yes

4. Do you lose your balance because of dizziness, or do you ever lose consciousness?

No Yes

5. Do you have a bone or joint problem (e.g. back, knee, hip, ankle) that could be made worse by physical activity?

No Yes

6. Is your doctor currently prescribing medication for a blood pressure or heart condition?

No Yes

7. Do you know of any other reason why you should not do physical activity, or any condition we should be aware of? (e.g. pregnancy, recent surgery, diabetes, epilepsy, asthma, eating disorder recovery, mental health condition)

No Yes

A Little More About You

How would you describe your current fitness level?

What are your main goals? (optional)

Anything else you'd like us to know? (optional)

Declaration

I confirm that the information I have provided is accurate and complete to the best of my knowledge. I understand that I should notify Orchard Wellness of any changes to my health that may affect my ability to exercise safely. I consent to Orchard Wellness storing and using this information to support my training. I have read and agree to the Privacy Policy. Community events & social activities (optional): I understand that Orchard Wellness occasionally organises informal community activities — such as social runs, walks, or cover sessions — which may be led by a participant or volunteer rather than a qualified fitness instructor. I am happy to take part in activities of this nature and accept that I do so at my own risk, taking personal responsibility for my participation.

Your information is stored securely and never shared with third parties.

✅

Thank you!

We've received your PAR-Q. Your coach will review it before your first session.
See you soon — we can't wait to welcome you. 🌿

© 2026 Orchard Wellness. All rights reserved. Rudgwick, West Sussex.

Privacy Policy Terms & Conditions