Documente Academic
Documente Profesional
Documente Cultură
( posibil a pacientului )
NUME..........................................................PRENUME..................................................................................
ADRESA...........................................................................................NR.TEL..................................................
OCUPAŢIA...............................................VÂRSTA..................SEX..........................ÎNĂLŢIME...............GREUTATE..
............PERIM. ŞOLD.............. PERIM. ABDOMINAL............ GR.SANGUINĂ ............
(VO2.MAX)....................................................................................................................................................
..............................................................................................................................................................................
..........................................................................................................................................................................
EVALUAREA CARDIO-RESP.
(I.R.)..................................................................................................................................................................
..............................................................................................................................................................................
..........................................................................................................................................................................
............................................................................................................................................................................
...........................................................................................................................................................................
...........................................................................................................................................................................
EVALUAREA
ADIPOZITĂŢII..........................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................
..........................................................................................................................................................................
ESTIMAREA DIETEI
NORMOCALORICE..................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
............................................................................................................................................................
.........................................................................................................................................................................
ESTIMAREA DIETEI
HIPOCALORICE.......................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................
.........................................................................................................................................................................
........................................................................................................................................................................
PREFERINŢE
ALIMENTARE..........................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
...........................................................................................................................................................
........................................................................................................................................................................
..........................................................................................................................................................................
MIC
DEJUN
PRANZ
CINA
OBS........................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
.........................................................................................................................................................................
.........................................................................................................................................................................
..........................................................................................................................................................................
ANTR.
1
OBS
.........................................................................................................................................................................
.........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
.........................................................................................................................................................................
.........................................................................................................................................................................
..........................................................................................................................................................................
..........................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
..............................................................................................................................................................................
.....................................................................................................................................................................