Fitness Assessment Form

Fitness Assessment Form

<p> Fitness Assessment Data Sheet</p><p>Name ______Date ______Age ______Wt ______Ht _____ Medications ______Risk Factor Status ______Resting HR ______Resting BP (1) ______(2) ______</p><p>Skinfolds: WOMEN MEN Triceps Pectoral Suprailiac Abdomen Thigh Thigh Estimated % Body Fat Waist to Hip Ratio (divide waist by hip) ______BMI ______Circumferences: Waist ______Hip ______Thigh ______Calf ______Upper arms ______Forearm ______</p><p>Step Test (60 sec. HR) ______Rockport Walking Test (60 sec. HR) ______Comments ______</p><p>Bench Press 1 RM ______/WT in lbs. ______= ______Crunch Test (#/min.) ______Push-up Test (total #) ______Sit and Reach (inches) ______</p><p>Muscle Specific Flexibility Test</p><p>Adequate Needs improvement Hamstrings ______Iliopsoas ______Quadriceps ______Calves ______Shoulders ______</p><p>Posture Assessments (visual) </p><p>Yes No Lordosis ______Kyphosis ______Forward head ______Hip height discrepancy ______Shoulder height ______</p>

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