Fitness Assessment Form (Page 3 of 6) in pdf

Fitness Assessment Form Page 3

MUSCULOSKELETAL

History of joint sprains, broken bones, torn muscles or ligaments, ongoing pains, etc

Comments

Feet/Toes Y/N _____________________________

Middle Back Y/N __________________________

Ankles Y/N ________________________________

Neck Y/N _________________________________

Lower Leg Y/N ____________________________

Shoulder Y/N ______________________________

Knees Y/N ________________________________

Upper Arm Y/N ____________________________

Upper Leg Y/N ____________________________

Elbow Y/N ________________________________

Pelvis/Hips Y/N ____________________________

Forearm Y/N ______________________________

Lower Back Y/N ___________________________

Wrist/fingers Y/N ___________________________

ACTIVITY HISTORY

Current and previous physical activity, sport, work, etc. Note activity, its frequency, intensity, how

long it was done for, and any comments.

1. ___________________________________________________________________________________________

2. ___________________________________________________________________________________________

3. ___________________________________________________________________________________________

4. ___________________________________________________________________________________________

GOALS

What do you want to achieve from a programme of physical training?

Specific measurements and in what timeframe:

1. ___________________________________________________________________________________________

2. ___________________________________________________________________________________________

3. ___________________________________________________________________________________________

Fitness Assessment Form Page 3