Answer the Physical Activity Readiness Questionnaire before completing this questionnaire. If you answer yes to any of these questions, then you should consult with your family physician to determine whether there is a potential problem with your participation in sports or vigorous training.
| Yes | No | Question |
|---|---|---|
| Do you plan to participate on an organized team that will play intense competitive sports (e.g., varsity team, traveling club team)? | ||
| If you plan to play a collision sport such as football, boxing, rugby, or ice hockey, have you been knocked unconscious more than one time? | ||
| Do you currently have symptoms (e.g., pain, dizziness) from a previous injury? | ||
| Do you currently have symptoms from a previous back injury, or do you experience back pain as a result of involvement in physical activity? | ||
| Do you have any other symptoms during physical activity that give you reason to be concerned about your health? |