"Self-assessment Fitness Chart Template"

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Name_________________________________
Self-Assessment Fitness Chart
My LT*
Fitnessgram
Make it?
Make it?
Wellness Area
My Fall Scores
ST# Goal
Score
ST Goal
Score
Goals
Scores
Yes or No
Yes or No
Age
PACER
1 Mile Run
Curl-Up
Trunk Lift
90 Degree Push-up
Modified Pull-Up
Flexed Arm Hang
Back-Saver Sit & Reach
Shoulder Stretch
*LT = Long-term Goal
#ST = Short-term Goal
Name_________________________________
Self-Assessment Fitness Chart
My LT*
Fitnessgram
Make it?
Make it?
Wellness Area
My Fall Scores
ST# Goal
Score
ST Goal
Score
Goals
Scores
Yes or No
Yes or No
Age
PACER
1 Mile Run
Curl-Up
Trunk Lift
90 Degree Push-up
Modified Pull-Up
Flexed Arm Hang
Back-Saver Sit & Reach
Shoulder Stretch
*LT = Long-term Goal
#ST = Short-term Goal