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Health Assessment

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Physical Base-Line

Physical Base-Line

What is your height?

What is your height?

What is your weight?

What is your weight?

Do you have knee issues?

Do you have knee issues?

[{"label":"I'm Fine","value":"I'm Fine"},{"label":"No Jumping","value":"No Jumping"},{"label":"Low Impact","value":"Low Impact"}]

Do you have breathing issues?

Do you have breathing issues?

[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"},{"label":"May be","value":"May be"}]

Do you have any other medical issues that may impact your exercise?

Do you have any other medical issues that may impact your exercise?

Do you have any other physical limitations that may impact you exercising?

Do you have any other physical limitations that may impact you exercising?

How many push-ups can you do at one time?

How many push-ups can you do at one time?

[{"label":"5-10","value":"5-10"},{"label":"10-20","value":"10-20"},{"label":"Over 20","value":"Over 20"}]

How long can you hold a plank?

How long can you hold a plank?

[{"label":"0-30 seconds","value":"0-30 seconds"}, {"label":"30-60 seconds","value":"30-60 seconds"}, {"label":"60-120 seconds","value":"60-120 seconds"}]

After doing jumping jacks for 30 seconds, how do you feel? Check the boxes that apply?

After doing jumping jacks for 30 seconds, how do you feel? Check the boxes that apply?

[{"label":"Great","value":"Great"}, {"label":"Winded","value":"Winded"}, {"label":"In pain","value":"In pain"}, {"label":"Ready to go again","value":"Ready to go again"}, {"label":"Could not finish","value":"Could not finish"}, {"label":"So-So","value":"So-So"}, {"label":"Heart pounding","value":"Heart pounding"}, {"label":"Horrible","value":"Horrible"}, {"label":"Head Ache","value":"Head Ache"}]

Health Assessment Reflection

Health Assessment Reflection

How did you feel after completing this health assessment?

How did you feel after completing this health assessment?

What did you find challenging about completing this health assessment?

What did you find challenging about completing this health assessment?

Mandatory responses not filled. 

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