PARQ​ 
Physical Activity Readiness Questionnaire

'Before I felt capable of nothing, now I feel capable of everything!'

Name
Email
DOB
Phone
Occupation
Emergency contact
Emergency number
What do you enjoy doing in your spare time?
What exercises do you like?
What exercises do you dislike?
What activity have you done in the last 4 weeks? 1-2x/3-4x/5+ a week
What activity have you done in the last 6 months? 1-2x/3-4x/5+ a week
Address
What do you like to eat and drink?
What do you dislike to eat a drink?
How much water do you drink a day?
How much alcohol do you drink a week?
What is your long term goal and why will this make you happy?
Do you currently eat 5 or more fruit and veg per day?
What days/time are you looking to train and where (home/park/gym)?
When do you want to achieve your goals?
What obstacles could get in the way?
How can we avoid this?
Do you have any heart conditions or have you experienced any chest pain?
Do you suffer with any respiratory issues?
Do you have dizzy spells or lose consciousness when exercising?
Do you have any joint issues that might be aggravated with exercise?
Are you on any medication that affects you when you exercise?
Do you smoke? If so, on average how many a day?
Please add any additional information here.
Do you have diabetes?
Where did you hear about Applebees Fitness?
Submit

Contact
details

Your information will be stored securely and not shared with any third parties. 

Activity

This will help me better understand your current level of fitness  and design a plan around you and your interests.  ​​

Diet

Be honest...

A small change now will make a big change later.

Goals

Make your goal ​​SMART

Specific
Measureable
Acheivable
Realistic
Time-Bound

Medical

If the answer is yes to any of these questions, please seek professional advice from your doctor or healthcare professional before commencing any new training program.

'I have done ok in the past but with Ben's help and support I have far exceeded my expectations'

'Privacy statement summary....

DATA PROTECTION POLICY – APPLEBEES FITNESS

Under the new General Data Protection Regulations (2018) Applebees Fitness has a Data Privacy Policy Statement which outlines all the ways in which we collect, use, share and store your data. This has been made available for you to read today and is always available on request. This information will be kept, used and secured in the ways outlined in the Privacy Statement.

In Summary for Personal Data:

Applebees Fitness's legal obligation is to retain information of our customers for the sole purpose of providing information and continued fitness training through any of our provided services.  

Upon completion of your Registration and PARQ (Physical Activity Readiness Questionnaire), all electronic files/records and information therein may be stored for as long as the client remains a client of Applebees Fitness; and thereafter for a period of up to 5 years of inactivity, under our statutory requirement. Information will be held electronically in files accessible only by Applebees Fitness management team, who are directly involved in client care or data entry processing of client records.

All information provided will be treated as confidential and will not be given to any other person(s)/organisations(s) without written consent of the client concerned. Please also note that it is your right to withdraw your consent/opt out at any time.