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1、健康和醴遹能押估表集HealthandFitnessAssessmentKit高级私人教穗事用ForAdvancedPersonalTrainer身SS状况安全冏卷查PAR-QFORM(葛年龄介乎15至69人士之冏卷)(AQuestionnaireforPeopleAged15to69).具姓名Name:曾具虢碉MembershipNo.:下安全回答以下咫IS(在逋用鹿口打上/就)Foryoursafety,pleaseanswerthefollowingquestionsbyticking(/)theappropriatebox()，攵有NO有（或不清楚）YESornotsure1.你的翳生
2、有否告你你的心睡有冏期加要求你只能在麟生建的情况下才能迤行通勤?Doesyourdoctoreversaidthatyouhaveaheartconditionandsothatyoushouldonlydophysicalactivityrecommendedbyadoctor?2.常你暹行速勤畤胸腔有否感到痛楚？Doyoufeelpaininyourchestwhenyoudophysicalactivity?3.在遇往一(0月，你曾否弑遇在没有通勤情况下出现胸腔痛楚感t?Inthepastmonth,didyouhavechestpainwhenyouwerenotdoingphysic
3、alactivity?4.你有否由於量而醇致失去平冲，或至失去知感？Doyouloseyourbalancebecauseofdizzinessordoyoueverloseconsciousness?5.你有否因改燮你的遥勤而禅致骨骼或随箭同题悲化的情况?Doyouhaveaboneorjointproblemthatcouldbemadeworsebyachangeinyourphysicalactivity?6.你的爵生工期存有否供!桀方给你用於血屋或心8等周题?Isyourdoctorcurrentlyprescribingdrugs(forexample,waterpills)for
4、yourbldpressureorheartcondition?7.你是否知道有可因素禅致你不遵勤的原因？Doyouknowofanyotherreasonswhyyoucannotdophysicalactivity?我已翘剧3明白及完成这冏卷。以上周题的答案均是本人所同意。Ihaveread,understoodandcompletedthisquestionnaire.Allquestionsareansweredtomyfullsatisfaction.笈署日期SignatureDateInstructionofPAR-Q身!辍安全尚卷耦查使用指引Ifyouansweredyestoo
5、neormorequestions若有的答案有一他践以上TalkwithyourdoctorbyphoneorinpersonBEFOREyoustartbecomingmuchmorephysicallyactiveorBEFOREyouhaveafitnessappraisal.TellyourdoctoraboutthePAR-OandwhichquestionsyouansweredYES.在你迤行速勤或能逾能押估之前，消现身或透遇前你的静生告你的野生有PAR-Q的资料及那些冏期再案的是有j。Youmaybeabletodoanyactivityyouwant-aslongasyous
6、tartslowlyandbuildupgradually.Or,youmayneedtorestrictyouractivitiestothosewhicharesafeforyou.Talkwithyourdoctoraboutthekindsofactivitiesyouwishtoparticipateinandfollowhis/heradvice.你奉能筵行任何通勤-但要在始畤聘强度降低，加逐潮提高。或你可能限制只能参典封你安全的通勤。利你的S3生有你希望多舆的述勤，她多考髓生的意见。Findoutwhichcommunityprogramsaresafeandhelpfulfor
7、you.再找封你合遒典安全的社曹城醴击IfyouansweredNOhonestlytoallPAR-Qquestions,youcanbereasonablysurethatyoucan:若你真？T地回答所仃的同题，她所有的答案是没有,你能别：startbecomingmuchmorephysicallyactive-beginslowlyandbuildupgradually.Thisisthesafestandeasiestwaytogo.迤行通勤（但要在始畤将强度降低，或逐潮提高。道是最安全及最容易的方法）takepartinafitnessappraisal-thisisanexce
8、llentwaytodetermineyourbasicfitnesssothatyoucanplanthebestwayforyoutoliveactively.筵行髓通能辞估（运是最好的方法测就你现在濡遒能状;兄，因此你能更有效舒这你的健康生活。）骈醴遹能押估表10人资料PersonalInformation姓名NameMMWMembershipno.Address男女MaIeFemaIeX%BodyFat(SkinfoId)男胸部女三三mMenChestiWomenTricepsAbdomenIM1.hitSuprailium珏Thigh三Thighm(*)Total(mm)估ttK百分
9、比EStimatedBOdyFatmsClassification%BodyFat(BIA)Wtt例Waist-hipratioH(Classification上身肌力及肌耐力测就UpperBodyMuscularStrength&Endurance日期三目DateItems1st2nd3rd4th最多俯0stMaximumNo.ofpush-upsffttClassification20MMINo.ofcrunchcompletedin20secClsificatlon身篇柔勒度BodyFlexibilityTrunkForwardFlexion(inch)glassificationImn
10、应涉：i5汹Gastrocnemius!Standard150-20,)快WDK11HamstringISlandard0i0)ffiK9l1.V:此性水面11liopsoasStdardbelowhofizomallevel)背IwI65)IMmiMDOai(StandardI65*)估计脂肪百分比（男性）PercentFatEStimatiOnSFOrMenAe（yar3:SumofIhreesidnladS182223-2728-3233-3738-4243-4748-5253-57-58&12182634424957657.381131736445260687.6849.19918-2
11、25.46.27.07A8.69.310.110.911.723-277.17.98.79.510.311.111.912.613.42832889610.411212.012.813.514.315.1333710.411212.012.813.614.415.215.916.7384212.012.813.614.415.215.916.717.518.343-4713.514.315.115.916.717.518.319.019.848-5215.015.86.617.418.118.919720521.3535716.417.218.018819.620.321.121.922.75
12、8-6217.818.519.320.120.921.722.523.324.163-6719.119.920.621.422.223.023.824.625.468-7220.321.121.922.723.524.325.125.826.6737721.522.323.123.924.725.526.327.027.878-8222.723.524.325.025.826.627.428.229.083-8723.824.625.326.126.927.728.529.330.1889224.825.626.427.228.028.829.630.331.1$3-9725.826.627.428.229.029.30.531.332.1910226.727.528.329.129.930.731.532.333.110310727.628.429.230.030.831.632.433.
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