COACHED BY ELLIE — HEALTH SCREENING

Physical Activity
Readiness Questionnaire

A few honest answers so I can train you safely, from day one.

This takes about 5 minutes. Please answer every question as accurately as you can — nothing here is used to judge you, only to make sure your programme is built safely around you. If anything changes after today (a new injury, medication, or diagnosis), just let me know and we'll update this together.

Section 01

About You

Your details, and someone we can contact if we ever need to.

Full name *

Date of birth *

Email address *

Phone number *

Home address (optional)

Emergency contact name *

Relationship *

Emergency contact phone *

Section 02

Readiness Screening

Seven standard questions used across the fitness industry to flag anything we should be mindful of. Answer honestly — a "yes" rarely stops us starting, it just shapes how we start.

Section 03

Health & Wellbeing

This is the detail that shapes your programme — please be thorough. Nothing here is shared beyond what's needed to train you safely.

Current or past injuries *Include anything that still affects movement, even old ones.

Medical conditions *e.g. asthma, high/low blood pressure, diabetes, joint conditions.

Medications *Anything you take regularly, including reason if you're comfortable sharing.

Allergies *

Pregnant, postpartum, or trying to conceive? *I'm pre & post-natal qualified — this helps me adapt your programme appropriately, at any stage.

Surgeries or hospitalisations in the last 2 years

Section 04

Goals & Training Background

So your programme is built around where you're starting from, and where you want to get to.

Training experience *

Current weekly activity

Your main goals *

Anything else I should know?

Section 05

Your Data, Explained

Required reading before you consent below — kept short on purpose.

Read the full privacy notice

Who's responsible for your data

Ellie O'Gorman, trading as Coached by Ellie ("I", "me"), is the data controller for the information on this form. Contact: ellie.ogorman@hotmail.com · 07792 159565.

What I collect, and why

Your contact details, emergency contact, and health information (including details that UK GDPR classes as "special category data" — medical conditions, injuries, medications, and pregnancy status). I collect this to assess whether it's safe for you to train, to design and adapt your programme, and to respond appropriately in an emergency.

My lawful basis

For your contact and emergency details: performance of our coaching agreement and my legitimate interest in delivering a safe service. For health data specifically: your explicit consent, given below (UK GDPR Article 9(2)(a)), which you can withdraw at any time by contacting me.

How long I keep it

For the duration of our coaching relationship, and for up to 6 years afterwards, in line with standard practice for insurance and professional liability purposes. After that, it's securely deleted.

Who sees it

Only me. I don't sell, share, or use your data for anything beyond coaching you, except where I'm legally required to (e.g. a medical emergency, or a lawful request from an authority).

Your rights

You can ask to see the data I hold on you, ask me to correct or delete it, restrict how I use it, or request a copy in a portable format. You can also withdraw consent at any time — this won't affect training that's already happened. If you're ever unhappy with how your data is handled, you have the right to complain to the Information Commissioner's Office (ico.org.uk).

How it's stored

Your answers are submitted directly and securely to Ellie when you submit this form. They aren't stored anywhere public, and only Ellie can see them.

Section 06

Declarations

Please read and tick each one — these are all required except where marked optional.

Type your full name as your signature *

Date *

Almost there

Review & Submit

Here's a copy of everything you've entered. Click "Submit My PAR-Q" to send it straight to Ellie. If anything goes wrong, use Copy or Download below and email your answers to ellie.ogorman@hotmail.com yourself.

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Thank you — see you at the studio.

Your answers have gone straight to Ellie. She'll follow up if she has any questions before your first session.

Keep a backup, just in case

Your answers are saved here too. If Ellie doesn't confirm she's received them, copy or download this and email it to ellie.ogorman@hotmail.com yourself.