Olly Banks Personal Training
OB New Client Form

Health Questionnaire & Agreement

Before your first session, please complete this short health questionnaire (PAR-Q) and agreement, and sign at the bottom. It helps me train you safely and effectively. Your information is kept confidential and used only for your coaching.

Prefer paper? Download the printable PDF version →

Your Details
Physical Activity Readiness (PAR-Q)

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 medication for your blood pressure or a heart condition?

7.Do you know of any other reason why you should not do physical activity?

If you answered Yes to any question above, please consult your GP before starting and let me know.

Agreement & Disclaimer

Please read and confirm the following. Full terms are on the Legal & Disclaimer page.

Signature
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