Agewell Programme

Physical Activity Readiness Questionnaire

This questionnaire relates to general medical history. For most people physical activity does not pose a problem or hazard. This questionnaire is designed to help us tailor your exercise programme to your needs and help identify the small number of people for whom physical activity might be inappropriate.

Common sense is your best guide to answering these questions. Please read them carefully, ticking either yes or no and giving further information as necessary. If you have any questions about this form, please ask your tutor or telephone 020 8753 3600.


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