Member full name (as it appears on membership record)
Date of birth
Membership number or reference
Date form completed
Known heart condition: has a doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? (Yes / No)
Chest pain during activity: do you feel pain in your chest when you do physical activity? (Yes / No)
All checks done
Safety
PAR-Q & Health Commitment Statement
The PAR-Q and Health Commitment Statement is the pre-activity health screening record a new gym or leisure facility member completes before exercising for the first time. Without it, an operator has no documented evidence of meeting their duty of care under the Health and Safety at Work etc. Act 1974 (sections 2 and 3) and no defence against a personal injury claim that could be brought up to three years from the date of the incident under the Limitation Act 1980 (section 11).
14 checksPDF + printReviewed August 2026
Built on published UK guidance Show sources
Health and Safety at Work etc. Act 1974, sections 2 and 3; Management of Health and Safety at Work Regulations 1999, regulation 3 (risk assessment duty); Limitation Act 1980, section 11 (three-year personal injury limitation period); UK General Data Protection Regulation, Article 6 (lawful basis) and Article 9(2)(a) and 9(2)(c) (special category conditions); Data Protection Act 2018, Schedule 1; ukactive Health Commitment Statement guidance
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What’s on it
14 things to check.
Everything that matters, nothing that does not. Here is the full list, exactly as it appears on the template.
1Member full name (as it appears on membership record)
2Date of birth
3Membership number or reference
4Date form completed
5Known heart condition: has a doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? (Yes / No)
6Chest pain during activity: do you feel pain in your chest when you do physical activity? (Yes / No)
7Chest pain at rest: in the past month, have you had chest pain when you were not doing physical activity? (Yes / No)
8Dizziness or loss of consciousness: do you lose your balance because of dizziness, or do you ever lose consciousness? (Yes / No)
9Bone or joint problem: 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? (Yes / No)
10Prescribed medication for blood pressure or heart condition: is a doctor currently prescribing medication for your blood pressure or heart condition? (Yes / No)
11Pregnancy or recent birth: are you currently pregnant or have you given birth in the last 6 months? (Yes / No)
12Any other reason not to exercise: do you know of any other reason why you should not do physical activity? (Yes / No; if yes, please give details)
13Member declaration and signature: I confirm the information I have given is accurate and complete to the best of my knowledge. I understand I must inform staff if my health changes. I accept personal responsibility for my own health and safety during exercise and commit to seeking medical clearance if advised
14Staff name, role, and signature (confirming the form was received, any referral action noted)
Good to know
Health data collected on a PAR-Q form is special category data under UK GDPR Article 9. A gym must identify both a lawful basis under Article 6 (typically legitimate interests or contract performance) and a specific Article 9 condition (typically explicit consent under Article 9(2)(a) or vital interests under Article 9(2)(c)) before processing it. The Information Commissioner's Office confirms that processing without satisfying both layers is unlawful regardless of the safety purpose. There is no fixed statutory retention period in UK law for PAR-Q records, but industry practice aligned to the Limitation Act 1980 (section 11) is to retain them for the duration of membership plus three years after the last date of attendance, to cover potential personal injury claims.
Source: Health and Safety at Work etc. Act 1974, sections 2 and 3; Management of Health and Safety at Work Regulations 1999, regulation 3 (risk assessment duty); Limitation Act 1980, section 11 (three-year personal injury limitation period); UK General Data Protection Regulation, Article 6 (lawful basis) and Article 9(2)(a) and 9(2)(c) (special category conditions); Data Protection Act 2018, Schedule 1; ukactive Health Commitment Statement guidance
Good to know
Questions, answered
What is the PAR-Q & Health Commitment Statement?
The PAR-Q and Health Commitment Statement is the pre-activity health screening record a new gym or leisure facility member completes before exercising for the first time. Without it, an operator has no documented evidence of meeting their duty of care under the Health and Safety at Work etc. Act 1974 (sections 2 and 3) and no defence against a personal injury claim that could be brought up to three years from the date of the incident under the Limitation Act 1980 (section 11).
Why does it matter?
Health data collected on a PAR-Q form is special category data under UK GDPR Article 9. A gym must identify both a lawful basis under Article 6 (typically legitimate interests or contract performance) and a specific Article 9 condition (typically explicit consent under Article 9(2)(a) or vital interests under Article 9(2)(c)) before processing it. The Information Commissioner's Office confirms that processing without satisfying both layers is unlawful regardless of the safety purpose. There is no fixed statutory retention period in UK law for PAR-Q records, but industry practice aligned to the Limitation Act 1980 (section 11) is to retain them for the duration of membership plus three years after the last date of attendance, to cover potential personal injury claims.
How do I get it, and is it up to date?
The PDF downloads the moment you check out, prints sharp in black and white, and opens on any phone. It is reviewed for August 2026 and you get any future update free when the official guidance changes.
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