Scribd
Upload
77 views

Module 3 - Exercise Prescription

This document is an exercise prescription form that allows a user to design their own fitness plan by filling in details of cardiovascular and resistance training exercises including duration, reps, and sets. The form also includes sections for frequency, intensity, time, and type of exercises. The goal is to create a customized weekly exercise routine.

Uploaded by

Nicole Finuliar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
77 views

Module 3 - Exercise Prescription

This document is an exercise prescription form that allows a user to design their own fitness plan by filling in details of cardiovascular and resistance training exercises including duration, reps, and sets. The form also includes sections for frequency, intensity, time, and type of exercises. The goal is to create a customized weekly exercise routine.

Uploaded by

Nicole Finuliar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

Name: Section: Schedule: Date:

Exercise Prescription Form


Instruction: Design your own fitness plan by filling out this form.
E.g. Exercise 1: Push Ups Duration: 1 minute Reps: 10 Sets: 2

● Cardiovascular Conditioning
✔ Warm-Up:
Exercise 1: _ Duration: _ mins. Reps: _ Sets:
Exercise 2: _ Duration: _ mins. Reps: _ Sets:
Exercise 3: _ Duration: _ mins. Reps: _ Sets:
Exercise 4: _ Duration: _ mins. Reps: _ Sets:

● Muscular Resistance Training


✔ Conditioning:
Exercise 1: _ Duration: _ mins. Reps: _ Sets:
Exercise 2: _ Duration: _ mins. Reps: _ Sets:
Exercise 3: _ Duration: _ mins. Reps: _ Sets:
Exercise 4: _ Duration: _ mins. Reps: _ Sets:
Exercise 5: _ Duration: _ mins. Reps: _ Sets:
Exercise 6: _ Duration: _ mins. Reps: _ Sets:
Exercise 7: _ Duration: _ mins. Reps: _ Sets:
Exercise 8: _ Duration: mins. Reps: _ Sets:
Exercise 9: _ Duration: _ mins. Reps: _ Sets:
Exercise 10: Duration: mins. Reps: Sets:

a. Frequency: x a week (put check on the day/s below)


Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Name: Section: Schedule: Date:

b. Intensity: (check your risk stratification)


Low Risk Moderate to High Intensity
Moderate Risk Low to Moderate Intensity
High Risk Low Intensity

c. Time: min/session min/week

d. Type: (check the exercises you will include in your program)


Cardiovascular
Muscular Strength
Walking
Push Ups
Brisk Walking Curl Up
Running Lunges
Biking Squat
Dancing Lifting Weights

Others:

✔ Cool Down:
Exercise 1: _ Duration: _ mins. Reps: _ Sets:
Exercise 2: _ Duration: _ mins. Reps: _ Sets:
Exercise 3: _ Duration: _ mins. Reps: _ Sets:
Exercise 4: _ Duration: _ mins. Reps: _ Sets:

You might also like