Physical Activity Readiness Questionnaire

Please detail below any injuries

Regular exercise is associated with many health benefits, yet any change of activity may increase the risk of injury. Completion of this questionnaire is a first step when planning to increase the amount of physical activity in life. Please read each question carefully and answer every question honestly on behalf of your child.

If you answered 'yes' to any of the above questions, talk with your doctor BEFORE you become more physically active. Tell your doctor of your intent to exercise and to which questions you answered 'yes'. If you honestly answered 'no' to all the questions you can be reasonably positive that you can safely increase your physical activity gradually. If your health changes to answer 'yes to any of the above questions seek guidance from a physician.