PAR-Q Assessment

Liability Waiver

Complete your PAR-Q form here to activate your access to the bikes.

Name*

Last name*

Date of Birth*

Age*

Phone*

Email*

Has any doctor told you that you have a heart problem or that you should only do physical activity under medical supervision?*

Yes

No

Do you feel chest pain when you engage in physical activity?*

Yes

No

Have you felt chest pain during the last month, even when not engaging in physical activity?*

Yes

No

Have you lost your balance due to dizziness or have you lost consciousness recently?*

Yes

No

Do you have any bone, muscle, or joint problems (for example, back, knees, hips, or ankles) that could get worse with exercise?*

Yes

No

Do you currently take medication for blood pressure, heart conditions, or any other health issue that might affect your ability to exercise?*

Yes

No

Do you know of any other reason why you should not engage in physical activity or why you should receive medical clearance before exercising?*

Yes

No

Are you pregnant?

Yes

No

Do you have diabetes?

Yes

No

Do you have asthma or another respiratory condition?

Yes

No

Have you had any surgery in the last 12 months?

Yes

No

If the previous answer is affirmative, please explain briefly.

Signature*

Participant Statement

I declare that the information provided is true and complete. I understand that this questionnaire does not replace a medical evaluation and that I am responsible for reporting any changes in my health status before participating in activities at Ritmo Fitness Studio.

I also understand that answering “No” to all questions does not guarantee that exercise is completely risk-free, and that answering “Yes” to any question does not necessarily mean that I cannot work out, it may mean that I need a medical evaluation beforehand.