| _______________________________________________________________________________ |
| Participant Name | Age |
| Resting Heart Rate (beats/min) __________________ |
| Resting Blood Pressure (mmHG) __________________ |
| Cholesterol
(mg/dL) |
Total ___________ |
HDL ____________ |
LDL
____________ |
| |
Ratio ___________ |
Triglycerides
____________________ |
|
| Blood Glucose (mg/dL) __________________ |
| Fitness Component |
Test |
Raw Measure |
Final |
| Body Composition |
Impedance |
__________ohms |
__________%fat |
| |
Skinfold Calipers |
|
__________%fat |
| |
-tricepts / chest |
__________mm |
|
| |
-hip / waist |
__________mm |
|
| |
-thigh |
__________mm |
|
| Body Mass Index |
Height |
__________in |
__________index |
| |
Weight |
__________lbs |
|
| Waist to Hip Ratio |
Waist Circumference |
__________in |
__________ratio |
| |
Hip Circumference |
__________in |
|
| Cardiovascular (Aerobic) |
Step Test |
__________pulse |
|
| |
Ergometer |
__________ml/O2/kg/min |
|
| |
1-Mile Walk |
__________time |
|
| |
|
__________pulse |
|
| Muscular Strength |
Chest Press |
__________lbs |
__________ratio |
| |
Leg Press |
__________lbs |
__________ratio |
| Muscular Endurance |
1 Min Sit-up |
__________reps |
|
| |
1 Min Push-up |
__________reps |
|
| Flexibility |
Sit & Reach |
__________in |
|
| Strength Ratio = Weight Pushed in lbs/Body Weight in lbsWaist to Hip Ratio = Waist Circumference/Hip Circumference
Body Mass Index = [Body Weight (lbs)/Height (in2)] x 725
|
|