Physical Assessment Page


1. Name_______________________ Period:_______ Year:___________

First of the term

2. weight_________ Date: ________
3. Resting pulse_________________
4. Your target zone:

220
-your age____________
.85 x = __________ X 70% = ____________

End of the turm

2. weight_________ Date: ________
3. Resting pulse_________________
4. Your target zone:

220
-your age____________
.85 x = __________ X 70% = ____________

5. Body Measurements: First of the term

Calf - (Right) _____________(Left) __________
Thigh - (Right) ____________(Left) __________
Waist - (Right) ____________ (Left) __________
Chest - (Right) ____________(Left) __________
Upper Arm - (Right) ________(Left) __________
Forearms - (Right) __________(Left) __________

5. Body Measurements: The end of the term

Calf - (Right) _____________(Left) __________
Thigh - (Right) ____________(Left) __________
Waist - (Right) ____________ (Left) __________
Chest - (Right) ____________(Left) ___________
Upper Arm - (Right) ________(Left) ___________
Forearms - (Right) __________(Left) ___________

6. Muscle endurance for two minutes:

Abdominals (sit ups) First of the term _____________ End of the term____________
Triceps (push ups) First of the term ____________ End of the term_____________

7. Cardiovascular Endurence:

Cooper 12 minute. Run. First of the term.....................
Laps ________
Fitness Level ________

4-5 Laps = Poor
5-6 Laps = Fair
6-7 Laps = Good
7 And Above Laps = Superior

Cooper 12 minute Run. End of the term
Laps ________
Fitness Level ________

4-5 Laps = Poor
5-6 Laps = Fair
6-7 Laps = Good
7 And Above Laps = Superior

8. Set Your Goals. Only You Can Make An Improvement In your Scores

First of the term

Free Bench Press _______
Military Press _______
Incline Bench Press _________
Indoor Mile _______
Outdoor Mile _______
Rope Jump _______
40 Yard Dash _______
Written Exam _______
Sit Ups _______
Peg Board _______
Dips _______
Pull Ups _______
Curls _______
440 _______
25 Minute Run _______
Final Grade _______

End of the term. Did you reach your goal?

Free Bench Press _______
Military Press _______
Incline Bench Press _______
Indoor Mile _______
Outdoor Mile _______
Rope Jump _______
40 Yard Dash _______
Written Exam _______
Sit Ups _______
Peg Board _______
Dips _______
Pull Ups _______
Curls _______
440 _______
25 Minute Run _______
Final Grade _______

9. Name three goals that you would like to achieve this term.

1.

2.

3.

Pathways To Your goals

I. PROPER DIET. EAT A WELL BALANCED MEAL.
2. USE CLASS TIME WELL.
3. USE CHARTS AND HANDOUTS.
4. POSITIVE SELF-TALK.
5. DO EXTRA WORK.
6. SET REALISTIC GOALS.
7. CHALLENGE A FRIEND.
8. BE MENTALLY TOUGH.
9. STUDY OUTSIDE OF CLASS.
10. ASK FOR HELP WHEN YOU NEED IT.

IN THIS CLASS I WOULD LIKE TO :

GAIN WEIGHT______ LOOSE WEIGHT________ STAY THE SAME_____

BULID ENDURANCE_________ MUSCLE STRENGTH______ BOTH_________