Scribd
Upload
1K views

Physical Fitness Assessment Data Sheet

This physical fitness assessment data sheet records an individual's personal information, health history, body measurements, and physical fitness test results. It includes resting heart rate, blood pressure, weight, BMI, waist circumference, body fat percentage, and performance on step tests, pushups, situps, grip strength, and flexibility measures. Family history of heart disease and current smoking and cholesterol status are also noted.

Uploaded by

bhelelihle
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as RTF, PDF, TXT or read online on Scribd
1K views

Physical Fitness Assessment Data Sheet

This physical fitness assessment data sheet records an individual's personal information, health history, body measurements, and physical fitness test results. It includes resting heart rate, blood pressure, weight, BMI, waist circumference, body fat percentage, and performance on step tests, pushups, situps, grip strength, and flexibility measures. Family history of heart disease and current smoking and cholesterol status are also noted.

Uploaded by

bhelelihle
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as RTF, PDF, TXT or read online on Scribd
You are on page 1/ 1

PHYSICAL FITNESS ASSESSMENT DATA SHEET

Members name:___________________________________ Sex: Male /Female RESTING MEASURES Date of birth: _____/_____/19____ d m y Smoking status: yes / no Age: _______yrs If yes, how many /day: _________

Physical activity level: no exercise ; low ; mod-low ; mod ; mod-high ; high ; very high (please circle one of the above) How many family members with cardiac heart disease before 60?:_________ after 60?: ________ Blood cholesterol level status: healthy; low risk, moderate risk, high risk (please circle one of the above) Any ailment/sickness/ medication which may hamper or influence your physical fitness assessment? If yes please list: Resting heart rate:_______ beats/min Body weight:________ kg Body Mass Index: _______ Resting blood pressure: _______/______mmHG

Body height : _________ (m) Waist/hip ratio: ________ Hip circumference: _________cm (widest)

Waist circumference: ________cm (navel)

Skinfold measures: triceps___________ ilium____________ thigh__________TOTAL:_________ LIPOTRAK BODY COMPOSITION MEASURES Fat weight: ________ kg Lean weight: _______kg Lipotrak impedance:_______ ohms Fat % :__________ % Lean %:_________ % BMI: ____________ ACTIVE MEASURES 3- min. sub max step test: _________ (recovery heart beats/min) handgrip strength test: right hand __________kg TOTAL 1-min timed sit ups : _________reps /min left hand __________kg

__________kg 1-min timed push ups: _________reps /min

Flexibility (sit and reach): _________ (inches/cm)

You might also like