Coordinator's Guide Contents
 
SAMPLE DATABASE

Registration for civilian health promotion program

 

Last Name 
 
First Name 
 
Directorate 
 
Phone 
 
ACTIVITY LOGS

  • Month 1 _____
  • Month 2 _____
  • Month 3 _____
  • Month 4 _____
  • Month 5 _____
  • Month 6 _____
    		• REQUIRED FORMS

    Informed Consent _____
    Medical Considerations _____
    Health History _____
    Symptom Inventory _____
    Physician Referral/Approval _____
    MOU Participant _____
    MOU Participant/Supervisor _____
    Physical Fitness Assessment Sheet _____
    Health and Fitness Profile _____
    Post Assessment Referral _____
    Goal Sheet _____
    Registration Letter _____

     

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    US Army Center for Health Promotion and Preventive Medicine.