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REGISTRATION FOR CIVILIAN FITNESS 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 Form _____
    Symptom Inventory _____
    Physician Referral/Approval _____
    MOU Participant _____
    MOU Supervisor/Director _____
    Fitness Data Sheet _____
    Health History Profile _____
    Risk Factor Referral _____
    Training Worksheet _____
    Goal Sheet/Personal Info _____
    Registration Letter _____

     

     


    US Army Center for Health Promotion and Preventive Medicine.