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Walking Club Screening Test

TIP #1: PHYSICAL ACTIVITY READINESS QUESTIONNAIRE
Walking Club Logo**Before you begin any walking program, answer the questions below. If you answer "yes" to any of these questions, check with your doctor before beginning.**



YES or NO

1. Has a doctor said that you have a heart condition and recommened only medically supervised activity?

2. Do you have chest pain brought on by physical activity?

3. Have you developed chest pain in the past month?

4. Do you tend to lose consciousness or fall over as a result of dizziness?

5. Do you have a bone/joint that could be aggravated by the proposed physical activity?

6. Has a doctor ever recommended medication for your blood pressure or heart condition?

7. Are you aware through your own experience or a doctor's advice, of any other physical reason against your exercising without medical supervision?

NOTE: If you have a temporary illness, such as a common cold or are not feeling well at this time, postpone starting a walking regimen.

From: Shephard, RJ Thomas, S., and Weller, I. (1991). "The Canadian Home Fitness Test: 1991 Update," Used by permission.

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