PAR-Q

The information is this form is required to know a little more about you and if you are fit and healthy for the service that you require from Physicole Fitness. With the use of Physicole Fitness app you have access to booking in for physical activity and it is important that you are fit and healthy.
The information within this form will be held for the maximum of 12 months and you will recieve a copy of this form as a PDF sent by email for your records. There will be additional forms to fill in for further services.

Being physically active is very safe for most people. Some people, however, should check with their doctors before they increase their current level of activity. The PAR-Q has been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.

1) Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
2) Do you feel pain in your chest when you do physical activity?
3) In the past month, have you had chest pain when you were not doing physical activity?
4) Do you lose your balance because of dizziness or do you ever lose consciousness?
5) Do you have a bone or joint problem that could be made worse by a change in your physical activity?
6) Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
7) Do you know of any other reason why you should not do physical activity?8) Are you pregnant?

If you answered yes to one or more questions, are older than age 40 and have been inactive or are concerned about your health, consult a physician before taking a fitness test or substantially increasing your physical activity. You should ask for a medical clearance along with information about specific exercise limitations you may have.

 
In most cases, you will still be able to do any type of activity you want as long as you adhere to some guidelines.

If you are not feeling well because of a temporary illness, such as a cold or a fever, wait until you feel better to begin exercising.

If you are or may be pregnant, talk with your doctor before you start becoming more active.
 
Keep in mind, that if your health changes, so that you then answer "YES" to any of the above questions, tell your fitness or health professional, and ask whether you should change your physical activity plan.

If you answered no to all the PAR-Q questions, you can be reasonably sure that you can exercise safely and have a low risk of having any medical complications from exercise. It is still important to start slowing and increase gradually. It may also be helpful to have a fitness assessment with a personal trainer or coach in order to determine where to begin.

It is important that before any massage in the future you let your therpaist know if you have any of the below. Please familiarise yourself with these. You will be asked prior to a massage session to fill in some paperwork explaining what and why you want treatment for.

TOTAL CONTRAINDICATIONS:
If you have any of these treatment cannot go ahead.
Fever, Contagious Diseases, Cold or Flu, Under the Influence of Drugs and Alcohol, Recent Operations, Acute Injuries, Neuritis, Skin Diseases, Pregnancy.

LOCAL CONTRAINDICATIONS
We can massage but not over affected affected by:
Varicose Veins, Undiagnosed Lumps or Bumps, Bruising, Cuts, Abrasions, Undiagnosed Pain, Inflammation, Arthritis, Sunburn 

MEDICAL CONTRAINDICATIONS
If you suffer from any of the following conditions, massage can take place once it has been approved by a doctor in writing.
Cardio-Vascular Conditions (Thrombosis, Phlebitis, Hypertensions, Heart Conditions), Oedema, Psoriasis or Eczema, High Blood Pressure, Osteoporosis, Cancer, Nervous or Psychotic Conditions, Heart Problems, Angina, Epilepsy, Diabetes, Bell's Palsy, Trapped or Pinched Nerves, Gynecological Infections.

1) I hear-by request and consent to the performance of Personal Training, Online Coaching and/or Massage on me by David Cole or any other qualified Personal Trainer/ Massage Therapists working for Physicole Fitness.

2) I understand that during the course of the training / massage with Physicole Fitness. I will have to wear sports gear therefore suitable clothing will be worn.

3) I understand that the results of training / massages are not 100% garunteed and it will take time - this is not a quick fix. I may experience some discomfort following sessions from 24 - 72 hours.

4) I understand that I can contact the trainer/therpaist if I have any concerns or require any further advice regarding my sessions.

5) I understand that any children under the age of 16 must be accompanied by a parent/legal guardian, through all massage treatment with Physicole Fitness.

6) Your records are confidential with Physicole Fitness and will not be shared with other parties without your prior permission. On occasions your trainer may need to contact your GP and will only do so with your consent.

7) I have read the above and I have also had the opportunity to ask questions about its content.

I intend this consent form to cover the entire course of treatments and for any future treatment(s) for which I may seek.

I understand that I can with draw my consent at any time.

Informed Use of the PAR-Q: The Personal Trainer assumes no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

NOTE: The PAR-Q is a legal agreement between the client and personal trainer and may be used for legal and/or administrative purposes.