"Fitness Assessment Form - Denver Parks & Recreation"

ADVERTISEMENT
ADVERTISEMENT

Download "Fitness Assessment Form - Denver Parks & Recreation"

Download PDF

Fill PDF online

Rate (4.8 / 5) 16 votes
Denver Parks & Recreation Fitness Assessment
Full Name: __________________________________________________________ Date: __________________
Phone Number: ______________________________________________________
Email Address: ______________________________________________________
1. What is your primary fitness goal? ____________________________________________________________
____________________________________________________________________________________________
2. What time frame have you established for achieving this goal? ____________________________________
3. How committed are you to achieving this goal? ______________ [scale of 1-10]
4. Have you ever participated in a workout program in the past? _______________
5. How long was this program and what activities did it include? ____________________________________
____________________________________________________________________________________________
6. Did you enjoy this workout program? ________________
7. How happy were you with the results of the above program? ___________ [scale of 1-10]
8. How you ever worked with a personal trainer in the past? If so, when? _____________________________
9. Are you currently working out? _______________
10. If so, how many days per week and how long have you been consistent with this workout regimen?
____________________________________________________________________________________________
11. When were you in the best shape of your life? _________________________________________________
12. What activities were you involved in at that time? ______________________________________________
13. What activities do you enjoy now? ___________________________________________________________
14. How many days per week does exercise fit into your lifestyle? _____________
15. How often do you eat out?___________________
16. How do you rate your current health at this time? _____________ [scale of 1-10]
17. How would you rate your health as a priority in your life? ________________ [scale of 1-10]
18. What is your present weight? ____________
19. How long have you been at this weight? ____________
20. What is your desired weight? ____________
****************************************************************************************************************
Denver Parks & Recreation Fitness Assessment
Full Name: __________________________________________________________ Date: __________________
Phone Number: ______________________________________________________
Email Address: ______________________________________________________
1. What is your primary fitness goal? ____________________________________________________________
____________________________________________________________________________________________
2. What time frame have you established for achieving this goal? ____________________________________
3. How committed are you to achieving this goal? ______________ [scale of 1-10]
4. Have you ever participated in a workout program in the past? _______________
5. How long was this program and what activities did it include? ____________________________________
____________________________________________________________________________________________
6. Did you enjoy this workout program? ________________
7. How happy were you with the results of the above program? ___________ [scale of 1-10]
8. How you ever worked with a personal trainer in the past? If so, when? _____________________________
9. Are you currently working out? _______________
10. If so, how many days per week and how long have you been consistent with this workout regimen?
____________________________________________________________________________________________
11. When were you in the best shape of your life? _________________________________________________
12. What activities were you involved in at that time? ______________________________________________
13. What activities do you enjoy now? ___________________________________________________________
14. How many days per week does exercise fit into your lifestyle? _____________
15. How often do you eat out?___________________
16. How do you rate your current health at this time? _____________ [scale of 1-10]
17. How would you rate your health as a priority in your life? ________________ [scale of 1-10]
18. What is your present weight? ____________
19. How long have you been at this weight? ____________
20. What is your desired weight? ____________
****************************************************************************************************************
ASSESSMENT:
HANDHELD ANALYZER
BODY FAT %: __________ BMI: __________
AND/OR
7-SITE BODY COMPOSITION:
CHEST: ______ ______ ______ TRICEP: ______ ______ ______ SUBSCAPULAR: ______ ______ ______
MIDAXILLARY: ______ ______ ______ SUPRAILIAC: ______ ______ ______
ABDOMINAL: ______ ______ ______ THIGH: ______ ______ ______
CIRCUMFRENCES:
CHEST: _________
WAIST: _________
HIPS: _________
BICEP: (R)________ (L)________
THIGH: (R)________ (L)________
CALF: (R)________ (L)________
BLOOD PRESSURE:______________
RESTING HEART RATE:_____________
MUSCULAR STRENGTH/ENDURANCE: Circle Choice
Number of pushups (1-minute):__________ (Knees OR Toes)
Plank Hold Time (hold as long as possible with good form):__________ (Knees OR Toes)
ADDITIONAL NOTES:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Page of 2