The PAR-Q+ and ePARmed-X+: As easy as 1, 2, 3.

In 2007, an international collaboration (PAR-Q+ Collaboration) launched the PAR‑Q+ and ePARmed‑X+ to modernize pre‑participation screening, lower barriers to physical activity, and ensure safety across all ages and health statuses. Grounded in systematic reviews of over 540,000 citations and more than 1,000 key studies, the tools incorporate 60+ evidence‑based recommendations spanning pregnancy and eight clinical domains—cardiovascular, metabolic, orthopaedic, cancer, psychological, respiratory, spinal cord injury, and stroke—developed according to AGREE Instrument standards. The resulting tools feature no age restrictions, self‑administration, and a three‑step risk‑stratification process that integrates the role of qualified exercise professionals. Step One: Clients complete seven general health questions on the PAR-Q+; all “No” responses clear them for unrestricted activity with general exercise guidelines and a signed Participant Declaration. Any “Yes” leads to follow‑up. Step Two: Clients with a “Yes” response on Page 1 complete the follow-up questions on Pages 2–3 concerning chronic conditions; all “No” responses allow self‑clearance with tailored exercise advice, while any “Yes” directs clients to the ePARmed‑X+ and/or a qualified exercise professional. Step Three: Through the ePARmed‑X+ and/or professional consultation, clients are stratified into low, intermediate, or high risk—guiding supervision level or physician referral. This streamlined approach reduces physician referrals to approximately 1% (versus 15% under the original PAR‑Q), emphasizes that physical inactivity poses greater risk than exercise, and empowers individuals of all ages and health statuses to participate safely in physical activity. Anticipated to reach millions around the globe, the PAR-Q+ and ePARmed-X+ have significantly reduced barriers to physical activity participation for individuals across the lifespan.