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Employee –

Division:

General Information

Unique ID:

Employee #:

Test Date:

Age:

Gender:

Physiological Data

Cardio Data

Height (inches):

Weight (lbs):

Weight (kg):

Body Mass Index (BMI):

Resting HR:

Systolic Pressure (mm/Hg):

Target HR:

Body Composition (males)

Body Composition (females)

Triceps:

Subscapular:

Pectoral:

Sum of skinfolds:

% Body Fat:

Triceps:

Abdominal:

Suprailiac:

Sum of skinfolds:

% body fat:

Aerobic Capacity

Treadmill Test Stopped (y/n):

Treadmill Time (minutes/decimal):

Treadmill METS (mmO2/kg/min):

Treadmill VO2 Max (mmO2/min/kg):

Stepmill Test Stopped (y/n):

Stepmill Time (minutes/decimal):

Stepmill METS (mmO2/kg/min):

Stepmill VO2 Max (mmO2/min/kg):

Strength

Endurance

Right Grip (kg):

Left Grip (kg):

Jump Test (cm):

Leg Strength (watts):

Arm Curl (lbs):

Plank Time (decimal):

Push-Ups (max #):

Curl-Ups (max #):

Flexibility (inches):