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Physical Fitness Pre-test

Name: _________________________ Course/Yr. & Sec.: __________

Age: _________ Sex: _________

Part I: Health-Related Fitness

A. Body Composition (Body Mass Index)
Height (m): ________ Weight (kg): _________ BMI: __________

Classification: ________________________

B. Waist Circumference
(cm): ________ (in): _________ Risk: _______________

C. Flexibility (Sit & Reach)

(cm/inch) 1st result: ______ 2nd result: ______ 3rd result: ______

Average: _________

D. Cardiovascular Endurance (3-Minute Step Test)

Heart Rate (before the test): ________

Heart Rate (after the test): ________
Rating (based on age): ______________

E. Strength (Push-up)

Number of Push-ups: __________

PATH FIT 1 – Movement Enhancement

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Part II: Skill-Related Fitness

A. Speed (60-Meter Sprint)
1st result (time): ________ 2nd result (time): _________
3rd result (time): __________

B. Power (Vertical Jump)

1st result (distance in cm/in): ________
2nd result (distance in cm/in): ________
3rd result (distance in cm/in): ________

C. Agility (Hexagon Agility Test)

Clockwise Counter Clockwise

1st result (time): ________ ________
nd
2 result (time): ________ ________
3rd result (time): ________ ________

D. Reaction Time (Ruler Drop Test)

1st result (cm): ________ 2nd result (cm): _______

3rd result (cm): ________

E. Balance (Stork Stand Test)

1st result (time): ________ 2nd result (time): _______

3rd result (time): ________

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Physical Activity Readiness

Questionnaire (PAR-Q)
Name: _________________________________________ Date: ______________

Age: _________ Height: ______ (meter) Weight: ________ (kg.) BMI: _______

Questions: (encircle your answers)

Yes No 1. Has your doctor ever said that you have a heart condition and that you
should only perform physical activity recommended by a doctor?

Yes No 2. Do you feel pain in your chest when you perform physical activity?

Yes No 3. In the past month, have you had chest pain when you were not
performing
any physical activity?

Yes No 4. Do you lose your balance because of dizziness or do you ever lose
consciousness?

Yes No 5. Do you have a bone or joint problem that could be made worse by a
change in your physical activity?

Yes No 6. Is your doctor currently prescribing any medication for your blood pressure
or for a heart condition?

Yes No 7. Do you know of any other reason why you should not engage in physical
activity?

 If you have answered “Yes” to one or more of the above questions, consult your
physician before engaging in physical activity.
 Tell your physician which questions you answered “Yes” to.
 After a medical evaluation, seek advice from your physician on what type of
activity is suitable for your current condition.
 If you answered “NO” to all PAR-Q questions, you can be reasonably sure that
you can exercise safely and have a low risk of having any medical complications
from exercise. It is still important to start slowly and increase gradually. It may
also be helpful to have a fitness assessment with a personal trainer or coach in
order to determine where to begin.

I hereby certify that the above information given are true and correct as to the
best of my knowledge. In case any of the above information is found to be false, or
untrue or misleading or misrepresenting, I am aware that I may be held liable for it.

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___________________________________
Printed Name and Signature of Student

Gross Physical Assessment

Direction: Do this assessment with a partner. Turn your back for measurement. A
meter stick will be used for this test. Encircle the answer after a thorough observation

A. Shoulder Level
Right Shoulder Elevated Depressed Level
Left Shoulder Elevated Depressed Level
B. Pelvic Level
Right Pelvis Higher Lower Level
Left Pelvis Higher Lower Level
C. Knee Level
Right Knee Higher Lower Level
Left Knee Higher Lower Level
D. Ankle Level
Right Ankle Higher Lower Level
Left Ankle Higher Lower Level
E. Feet
Right Foot Inverted Everted Level
Left Foot Inverted Everted Level

Direction: Observe from the side and encircle the answer after a thorough observation.

Neck Protruded Hyperextended Level

Shoulder Protracted Retracted Neutral
Back Kyphotic Lordotic Scoliotic
Pelvis R turned in L turned in Level
Knee Hyperextended Level

PATH FIT 1 – Movement Enhancement