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Health Assessment
Assessment Information
Client Selection
(Required)
Select Client
Aaron Carter
Archie Hall
Brady Green
Branson Miller
Casey Radford
Colton Bennett
Cucumber & Company
Donny Adkins
Drew Bahr
Everly Morris
Exercise Physiologist - Kenji Ueda
Jackson Schroder
Jeff Miller
Kelli Schroder
Kenny Bryant
LeAndrea Quesenberry
Leann Umberger
Maddox Morris
Matt Morris
Matthew Morris
Megan Legursky
Rob Seiter
Steve Morgan
Wes Duncan
Zain Patel
Date of Assessment
(Required)
MM slash DD slash YYYY
Client Email
(Required)
Client Information
Gender
(Required)
Male
Female
Birthday
MM slash DD slash YYYY
Approximate Age
Body Composition
Height
(Required)
in inches.
Height
(Required)
converted to centimeters.
Weight
(Required)
Weight
(Required)
converted to kilograms.
Calf
in centimeters.
Thigh
in centimeters.
Hip
in centimeters.
Waist
in centimeters.
Chest
in centimeters.
Arm
in centimeters.
Neck
in centimeters.
TG
Body Mass Index
Body Fat (%)
Lean (%)
Heart Score
Test Selection
Select the test from the dropdown.
Sub Max Test
Max Test
Sub Max Test
Rockport
6 Minute Walk Test
Step Test
Max Test
1.5 Mile Run
12 Minute Cooper Run
Rockport Test
Time - Minutes
Total number of minutes taken.
Time - Seconds
Additional seconds taken.
Heartrate
VO² Max
6 Minute Walk Test
Distance Walked in Miles
(ex 1.15)
Heartrate
Systolic BP
mm Hg
VO
Step Test
Stepping Frequency
Steps/minute
Step Height
inches
VO2
Flexibility
Flexibility Test
Sit and Reach Test
FMS Test
Sit and Reach Test
Sit and Reach
in centimeters.
FMS Test
1. Deep Squat
Please enter a number from
0
to
3
.
Toe Touch Test
Able
Not Able
2. Hurdle Step
Please enter a number from
0
to
3
.
Inches
Left Leg Up
Please enter a number from
0
to
3
.
Right Leg Up
Please enter a number from
0
to
3
.
3. In-Line Lunge
Please enter a number from
0
to
3
.
Inches
Left Leg Forward
Please enter a number from
0
to
3
.
Right Leg Forward
Please enter a number from
0
to
3
.
4. Shoulder Mobility Distance:
Please enter a number from
0
to
3
.
(tip of middle finger to distal crease)
L Top:
R Top:
Impingement Test Left
Please enter a number from
0
to
3
.
Impingement Test Right
Please enter a number from
0
to
3
.
5. Active Straight Leg Raise
Please enter a number from
0
to
3
.
L
R
6. Truck Stability Push Up
Please enter a number from
0
to
3
.
Prone Press Up Test:
7. Rotary Stability Quadruped
Please enter a number from
0
to
3
.
Kneeling Lumbar Flexion Test
Please enter a number from
0
to
3
.
Left Up
Please enter a number from
0
to
3
.
Right Up
Please enter a number from
0
to
3
.
FMS Test Total
Muscle Endurance
Partial Curl Test
Muscle Strength
Muscle Strength Test
Bench Press
Squat
Bench Press
Squat
Speed
Speed Test
10 Yard Dash
40 Yard Dash
10 Yard Dash
seconds.
40 Yard Dash
seconds.
Agility
20 Yard Shuttle
seconds.
Power
Power Test
Vertical Jump
Broad Jump
Vertical Jump
inches.
Broad Jump
inches.
