BSF758: PARE Medical Clearance Form/Letter to Physician

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Dear Physician,

Subject: Medical Clearance to Undergo the Physical Abilities Requirement Evaluation

The person who has made this appointment with you is seeking a medical clearance to undergo the Physical Abilities Requirement Evaluation (PARE) as part of their application to become a CBSA officer trainee.

PARE is an occupational physical abilities test directly linked to law enforcement training. It is a maximal exertion test equivalent to an exercise stress test at the 12 MET level.

PARE represents a scenario where an officer must get to the scene of a problem, physically control the situation, and carry a person or an object away from the scene. The test is divided into the following three stations:

The first two sections (the obstacle course and the push/pull station) are timed. Applicants for the Canada Border Services Agency must complete these two sections in a time of 4:45 minutes or less.

Please complete, sign, date, and stamp the PARE medical clearance form. Please provide original copy to patient and keep a photocopy of the form on the patient's medical file. The original copy will be used as proof that the applicant has been medically cleared to undergo the PARE.

Should you require further information regarding the PARE, please contact the Canada Border Services Agency National Recruitment Unit at: CBSA-ASFC_National-Recruitment_recrutement-national.

National Recruitment Unit
Canada Border Services Agency

PARE Medical Clearance - Part 1

Patient Information

Surname
Given Name(s)
Age
Gender
Female
Male
Other
Height (cm)
Weight (kg)
Resting Heart Rate
Resting Blood Pressure

Risk Factors

Note to Physician The Physical Abilities Requirement Evaluation (PARE) is a maximal physical exertion test equivalent to an exercise stress test at the 12 Metabolic Equivalent for Task (MET) level. The following are risk factors to consider when assessing suitability for PARE.

Section A - For all Individuals - Pulmonary and Musculoskeletal Restrictions

If yes to any one risk factor in Section A, patient should not undertake PARE.
Pulmonary obstruction / restriction that would prevent maximal testing. (Yes / No)
Needs to use a short acting inhaler immediately prior to participate in maximal testing. (Short acting inhalers can only be used after the test if needed. Long acting or combined inhalers are allowed.) (Yes / No)
Musculoskeletal restrictions that could interfere with strenuous activities or maximal testing. (Yes / No)

Section B - For all Individuals - High or Very High Cardiovascular Risk Factors (ATP III 1 & CMAJ 2)

If yes to one or more risk factors in Section B, it is recommended to send the patient to an exercise stress test before clearing for PARE.
Previous CVA, MI, vascular surgery or any clinical evidence of atherosclerosis (Yes / No)
Diabetes 3 (Yes / No)
Metabolic Syndrome (Yes / No)

Section C - For Men > Age 40 and Women > Age 50 - Coronary Artery Disease Risk Factors (ACSM 4 & CSEP 5)

If yes to two or more risk factors in Section C, it is recommended to send the patient for an exercise stress test before clearing for PARE.
Family history of premature cardiovascular disease (Yes / No)
Cigarette smoking (Yes / No)
Hypertension 6 (Yes / No)
Dyslipidemia (Yes / No)
Abnormal fasting glucose level (Yes / No)
Obesity 7 (Yes / No)
Physical inactivity (Yes / No)

Section D - Exercise Stress Test (when required)

Clinically positive for ischemia (Yes / No)
Electrically positive for ischemia (Yes / No)
Number of MET reached (12 MET are required prior to undertaking PARE)
Additional tests (if needed, specify)

Medical References

1) Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. (Adult Treatment Panel III). National Institute of Health. National Heart, Lung and Blood Institute.
2) Recommendations for the Management of Dyslipidemia and the Prevention of Cardiovascular Disease: 2003 update. CMAJ appendix 2003; 168 (9) 921-924.
3) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2003; 26 (supp 1):S5-S20.
4) American College of Sports Medicine, Cited in ACSM Guidelines for Exercise Testing and Prescription, Seventh Edition. 2006.
5) Canadian Society of Exercise Physiology. Professional Fitness & Lifestyle Consultant. Resource Manual. 2004.
6) Canadian Recommendations for the Management of Hypertension (2005)
7) Canadian Guidelines for Body Weight Classification in Adults (2003)

PARE Medical Clearance - Part 2

Patient Information

Surname
Given Name(s)
Age
Gender
Female
Male
Other
Height (cm)
Weight (kg)
Resting Heart Rate
Resting Blood Pressure

Physician's Recommendations

After reviewing Part 1 of the PARE medical clearance and evaluating the following risk factors:

it is my professional opinion that the above named patient is:

Comments
Physician's stamp
Physician's signature
Date (yyyy-mm-dd)

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