FITNESS ASSESSMENT

Name

______________________________________

Ankle

R: ___________ L: ___________

Date

______________________________________

Calf

R: ___________ L: ___________

DOB/Age ______________________________________

Thigh

R: ___________ L: ___________

Height ________________ Weight _________________

Arm

R: ___________ L: ___________

RHR __________ BIA BF% __________ BMI __________

Forearm R: ___________ L: ___________

Wrist

R: ___________ L: ___________

Waist:Hip ____________ BF % (Tape) ___________

Waist 1 ___________ W2 ____________

Lean Mass ____________ Fat Mass _____________

Hips __________ Neck ___________

Est. VO2 Max _______________

(Chest) _____________

Push-Up Test

_________________________

10RM Squat

_________________________

Half Sit-Up Test

_________________________

10RM Deadlift

_________________________

Chin-Up / FAH

_________________________

YMCA Bench Press _________________________

Pull-Up / Lat Pull _________________________

Pollof Press R

_________________________

10RM Bench Press _________________________

Pollof Press L

_________________________

3 Step Test

Pace ____________ Time ____________ RPE ____________ HR ____________

Mile Walk Test Pace ____________ Time ____________ RPE ____________ HR ____________
Mile Jog Test

Pace ____________ Time ____________ RPE ____________ HR ____________

Sit/Reach __________ Trunk _______/________ Hip ______/_______ Shoulder _______/________

Standing Balance _____________________________________________________________________
O-Head Squat ________________________________________________________________________
Plank _______________________________________________________________________________
Lunge _______________________________________________________________________________