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    Physical Activity Readiness Questionnaire

    Uploaded by

    Camille Bianca David
    The document is a physical activity readiness questionnaire for a student named containing 7 yes or no questions. The questions ask about any heart conditions, chest pain during or not during physical activity, dizziness, bone or joint problems, medications, and any other reasons the student should not do physical activity. The student must sign to confirm they completed the questionnaire and had any questions answered.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Physical Activity Readiness Questionnaire

    Uploaded by

    Camille Bianca David
    30 views1 page
    The document is a physical activity readiness questionnaire for a student named containing 7 yes or no questions. The questions ask about any heart conditions, chest pain during or not during physical activity, dizziness, bone or joint problems, medications, and any other reasons the student should not do physical activity. The student must sign to confirm they completed the questionnaire and had any questions answered.

    Original Description:

    about physical education

    Original Title

    Physical-Activity-Readiness-Questionnaire

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    The document is a physical activity readiness questionnaire for a student named containing 7 yes or no questions. The questions ask about any heart conditions, chest pain during or not during physical activity, dizziness, bone or joint problems, medications, and any other reasons the student should not do physical activity. The student must sign to confirm they completed the questionnaire and had any questions answered.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views1 page

    Physical Activity Readiness Questionnaire

    Uploaded by

    Camille Bianca David
    The document is a physical activity readiness questionnaire for a student named containing 7 yes or no questions. The questions ask about any heart conditions, chest pain during or not during physical activity, dizziness, bone or joint problems, medications, and any other reasons the student should not do physical activity. The student must sign to confirm they completed the questionnaire and had any questions answered.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Physical Activity Readiness Questionnaire

    Health Optimizing Physical Education

    Name:____________________________________ Date:____________
    Year/Section ________________________
    Please read the questions carefully and answer each one honestly: Check YES or NO
    YES NO
    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 (for example, back, knee or hip) 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?

    "I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

    _________________________________________
    Signature of Student

    --------------------------------------------------------------------------------------------------------------------------------------------------

    Physical Activity Readiness Questionnaire


    Health Optimizing Physical Education
    Name:____________________________________ Date:____________
    Year/Section ________________________
    Please read the questions carefully and answer each one honestly: Check YES or NO
    YES NO
    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 (for example, back, knee or hip) 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?

    "I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

    _________________________________________
    Signature of Student

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