OriginalPIN:

ParQ:

PIN:

EmployeeID:

Badge #:

Division:

First Name:

Last Name:

Gender:

Test Date:

Birth Date:

Age:

Height (inches):

Height (cm):

Weight (lbs):

Weight (kg):

Body Mass Index:

Resting HR:

Systolic Press.:

Diastolic Press.:

Target HR:

MaleTriceps:

MaleSubscapular:

MalePectoral:

Sum of skinfolds:

Male Body Fat:

Male % Fat:

FemaleTriceps:

FemaleAbdominal:

FemaleSuprailiac:

Sum of Skinfolds:

Female Body Fat:

Female % Fat:

Treadmill Test Stopped (y/n):

Treadmill Time (decimal):

Treadmill VO2 Max (mmO2/min/kg):

Treadmill Calc. VO2max:

Treadmill METS:

Treadmill METS Calc.:

Stepmill Test Stopped:

Stepmill Time (decimal):

Stepmill VO2 Max (mmO2/min/kg):

Stepmill Calc. VO2max:

Stepmill METS:

Stepmill METS Calc.:

Right Grip (kg):

Left Grip (kg):

Jump Test (inches):

Leg Strength (watts):

Arm Curl (lbs):

Plank Time (decimal):

Push-Ups (max #):

Sit-Ups (max #):

Curl-Ups (max #):

Flexibility (inches):

Notes:

Photo: