LET'S BUILD A BETTER YOU.
  • Home
  • Coaching
    • PERSONAL
  • About
  • Contact
  • Number One Me!
  • Remote Coaching
  • Ready for Change?
Picture

    participant informatiON

    Please complete the form below and click the SUBMIT button to begin your journey.  Thank you!
    Please enter your birth year, e.g. "1973"

    physical activity readiness questionnaire 

    PAR – Q & YOU Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active. If you are planning to become much more physically active than you are now, start by answering the seven questions below. The PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one: CHOOSE YES or NO.
    Informed Use of the PAR-Q: Progressive Fitness Coaching, LLC and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.
    DELAY BECOMING MUCH MORE ACTIVE
    If you are not feeling well because of a
    temporary illness such as cold or a fever.
    Waituntil you feel better; or If you are or
    may be pregnant-talk to your doctor before
    NO to all ALL...
    If you answered NO honestly to all PAR-Q questions, you can
    reasonably sure that you can: Start becoming much more physically active – begin slowly and
    build up gradually. This is the safest and easiest way to go. Take part in a fitness appraisal – this is an excellent way to
    determine your basic fitness so that you can plan the best way for you to live actively.
    YES to one or more questions
    Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a
    fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES. You may be able to do any activity
    you want – as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are
    safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.  Find out which community programs are safe and helpful for you.

    CORONAVIRUS AND EXERCISE
    Individuals at most risk for the severe effects of coronavirus have other medical complications or a compromised immune system.
    Here are some simple recommendations to keep your immune system strong.
    1.Get a good night’s sleep. Sleep deprivation causes an increase in cortisol levels independent of exercise.

    2.Maintain hydration levels before during and after your workout. Dehydration increases the cortisol response
    3.Pay attention to refueling especially during a longer workout. Consuming a carbohydrate/protein sports drink during your workout will minimize cortisol elevation and muscle protein breakdown.
    4.Don't skip your recovery nutrition. Consuming a carbohydrate/protein recovery drink within 45 minutes post workout can pay dramatic dividends by reducing cortisol levels and minimize inflammation both factors which negatively impact your body's defense mechanisms.
    5.Reduce the number of high volume, high intensity workouts per week.
    6.Take a rest day after a particularly hard workout. This is a good practice even if there was not threat of coronavirus.
    Last but not least, don’t stop exercising. In this time of heightened anxiety nothing relieves mental and physical stress better than exercise plus the added benefit of keeping your immune system strong!

    INSTRUCTIONS
    This is your comprehensive participant information sheet, in which you are asked to provide some relevant personal
    information. The answers to these questions are essential in order to allow us to design an optimized individual
    fitness program for you. Please answer all questions in the most accurate manner possible while being as concise
    as possible.
    DISCLAIMER
    Please recognize the fact that it is your responsibility to work directly with your physician before, during, and after
    seeking fitness consultation. As such, any information provided is not to be followed without the prior approval of
    your physician. If you choose to use this information without the prior consent of your physician, you are agreeing to
    accept full responsibility for your decision.

    Part 1: basic information

    Relaxed from a seated or lying position, place two fingers on carotid artery (next to throat) and feel for pulse. Begin counting at Zero (0) and count your pulse for 15-seconds. Multiply this number by 4 to get your pulse rate.

    PART 2: GOALS

    ​Given the following goals, please rank them in order of importance, with 1 being most important
    Please select one

    PART 3: EXERCISE INFORMATION

    Please rate your ability in the following exercises (check the box that corresponds with your ability):
    If you answered YES above, continue on to the following section.
    If you answered NO, skip ahead to the section marked “Not currently exercising”.

    Complete this section if you ARE currently exercising regularly
    Please rank your most consistent to least consistent exercise routines/modalities 

    Complete this section if you ARE NOT currently exercising regularly

    PART 4: MEDICAL AND HEALTH INFORMATION

    Please complete as accurately as possible, or answer NA
    Respond "NA" if no additional therapies/interventions
    Please be as accurate as possible, or answer NA
    Check any conditions or diseases you now have or have had in the past. 

    PART 5: LIFESTYLE INFORMATION

    Any over-the-counter, prescription, or other sleeping aids
    Simply input activities you perform for leisure/recreation
    Informed Consent:
    Exercise has a great many benefits along with certain risks. I hereby expressly assume all delineated risks of injury, all other possible risks of injury, and even death, which could occur by reason of my participation in increased physical activity.
    Please choose YES or NO and complete your name below and submit
    Please enter your First and Last name, then click SUBMIT
Submit
Picture
Accountability. Motivation. Guidance. Support.

Picture

© 2022 Progressive Fitness Coaching, LLC. All Rights Reserved. PO Box 1076 Hockessin, DE 19707 (302) 521-1794

  • Home
  • Coaching
    • PERSONAL
  • About
  • Contact
  • Number One Me!
  • Remote Coaching
  • Ready for Change?