How to integrate a PAR-Q online as part of the purchasing process. Help!

Site URL: https://raspberry-lynx-kbja.squarespace.com

For all our dance workshops we need our customers to complete a Physical  Activity Readiness Questionnaire (PAR-Q). 

A simple easy solution would be for new accounts to complete this on their first purchase as part of the buying process. 

I know that you can include forms. However the Squarespace functionality does not give enough flexibility to support the amount of detail and supporting text needed in a PAR-Q. 

Has anyone come across a solution for this?

 

What information is needed in a form is:

 

Name

Phone

Date

Emergency Contact

Emergency Phone

Signature

Date

 

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active.

If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

In the past month, have you had chest pain when you were not doing physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

Do you know of any other reason why you should not do physical activity?

YES to one or more of the questions

Talk with your doctor by phone or in person BEFORE you start at one of our workshops or classes. Tell your doctor about the PAR-Q and which questions you answered YES.
 

You may be able to do any activity you want — as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. 

Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

 

IMPORTANT

 

INFORMED CONSENT

I hereby state that I have read, understood and answered honestly the questions above. I also state that I wish to participate in dance activities, which may include aerobic exercise, resistance exercise and stretching. I realise that my participation in these activities involves the risk of injury and even the possibility of death. 

Furthermore, I hereby confirm that I am voluntarily engaging in an acceptable level of exercise, which has been recommended to me.

If I have answered YES to one of the questions above, I have sought medical advice and my GP has agreed that I may exercise.

 

Note: 

This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the seven questions.

 

 

 

Hello NOCTURN! 

Did you ever find a solution to this issue? I'm putting together a website for a fitness/medical clinic and need to include the same form. Any tips you might have to share would be appreciated!

Thanks!

Colleen