About this template
Ensuring client safety before starting any new exercise program or fitness class is essential. This Physical Activity Readiness Google Form Template—modeled after standard PAR-Q guidelines—helps trainers, gym owners, and health practitioners screen participants for underlying health conditions, past injuries, and cardiac risk factors before they engage in physical exertion.
The form collects crucial background information, emergency contact details, and self-reported answers to standard medical screening questions regarding heart health, dizziness, joint issues, and chronic illnesses. By gathering these details upfront, fitness professionals can identify clients who may need physician clearance or tailored modifications during workouts, minimizing liability and ensuring a safer training environment.
Built for quick deployment, this template can be shared instantly via a link or QR code before a client's first class or personal training session. All responses are organized automatically in Google Sheets, allowing instructors to review medical histories quickly and securely from any device.
Key features
- Pre-screens participants for physical activity risks and limitations
- Collects emergency contact and primary physician information
- Fully customizable questions to match your specific studio or gym protocols
- Automatically organizes client responses in a secure spreadsheet
- Mobile-friendly design for easy completion on phones or tablets
Use cases
- New gym member onboarding and health history screening
- Pre-class health clearance for group fitness and yoga studios
- Personal training client assessment and risk evaluation
- Participant intake for bootcamps and athletic training programs
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)We will use this to send class confirmations and important updates.
- Phone Number (Short answer)Provide a number where we can reach you in case of schedule changes.
- Date of Birth (Date)Select your birth date.
- Emergency Contact Name (Short answer)Name of a family member or friend we can contact in an emergency.
- Emergency Contact Phone Number (Short answer)Direct phone number for your emergency contact.
- Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? (Multiple choice)Select your answer based on medical advice.
- Do you feel pain in your chest when you do physical activity? (Multiple choice)Consider any recent tightness, pressure, or pain.
- In the past month, have you had chest pain when you were not doing physical activity? (Multiple choice)Note any resting chest discomfort.
- Do you lose your balance because of dizziness or do you ever lose consciousness? (Multiple choice)Consider any history of fainting or severe lightheadedness.
- Do you have a bone or joint problem that could be made worse by a change in your physical activity? (Multiple choice)Include chronic issues with knees, hips, back, shoulders, etc.
- Is your doctor currently prescribing drugs for your blood pressure or heart condition? (Multiple choice)Include any routine cardiovascular or blood pressure medications.
- Do you know of any other reason why you should not do physical activity? (Paragraph)Mention any other conditions, recent surgeries, or medical advice we should be aware of.
- Participant Declaration (Multiple choice)I hereby state that I have read, understood, and accurately completed this questionnaire. I confirm that I am physically sound and able to participate in physical activities.
FAQ
How do I share this form with my clients?
Once you save the template to your Google Drive, simply click 'Send' to copy the form link, email it directly, or embed it on your website for clients to fill out before their first session.
Can I add or remove health questions?
Yes. Google Forms is fully customizable. You can easily add specific liability clauses, modify existing medical questions, or include fields for preferred workout times.
Where are the client responses stored?
All submissions go directly into your linked Google Sheet, giving you a centralized, searchable database of your participants' health statuses.
Is this form mobile-responsive?
Yes, Google Forms automatically adapts to look and function great on smartphones, tablets, and desktop computers.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.