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PTQ

    01 / Physical activity readiness questionnaire
    PERSONAL DETAILS
    02 / Pre Training Info
    A. Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?


    B. Do you feel pain in your chest when you perform physical activity?


    C. In the past month, have you had chest pain when you were not performing any physical activity?


    D. Do you lose your balance because of dizziness or do you ever lose consciousness?


    F. Do you have a bone or joint problem that could be made worse by a change in your physical activity?


    G. Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?


    H. Do you know of any other reason why you should not engage in physical


    If you answered “YES” on one of the questions listed above, please clarify here
    Any other conditions present (all info is relevant):
    INJURY HISTORY
    Previous injuries:
    TRAINING
    Training objectives (general fitness, sports performance, more specific goals, …):
    Favorite sports/training activities:
    Training history (sports/activities & how many years of experience):
    Current sports/training routines:
    Training availability/frequency in a regular week (…x/week ; Morning/Noon/Afternoon/Evening):
    LIFESTYLE
    Activity level (e.g. average amount of steps per day)
    Energy level during the day (rate 1-10)
    Sleep quality (rate 1-10)
    Do you currently take any medication (if yes, please clarify):





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