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Informed Consent Form Sample During a
fitness assessment or fitness re-assessment, your 2racy Trainer will
perform the measurements and tests shown below, unless they are
contraindicated (for example, no push-ups if a shoulder injury would be
aggravated).
|
MEASUREMENT OF |
USING |
MEASUREMENT OF |
USING |
|
Resting heart rate |
Heart rate monitor |
Body composition |
Skinfold caliper and /
or bioelectrical impedance body fat analyzer |
|
Resting blood pressure |
Stethoscope and
sphygmomanometer |
Cardio respiratory
system |
YMCA Submaximal
3-minute Step Test |
|
Height |
Height rod on scale |
Flexibility |
Sit-and-reach box |
|
Weight |
Scale |
Muscular strength
|
Push-ups |
|
Circumference
measurements |
Tape measure |
Muscular endurance |
Abdominal crunch test |
Medical
Clearance Sample Dear Doctor,
Tracy Walsh,
Owner
Sample
(PAR-Q) Form
Name (please print):
__________________________________ Birth date: ____/____/____
Age: _____
Yes
No Has a physician ever told you that you should perform only those
activities recommended by a physician?
Yes
No Do you feel chest pain when you perform physical activity?
Yes
No Do you lose your balance due to dizziness or ever lose
consciousness?
Yes
No Do you have a bone or joint problem that could worsen due to a
change in your physical activity?
Please check all of
the following risk factors that apply to you.
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