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Section 1
Section 2
Section
Physical Activity Readiness Questionnaire
A Questionnaire for People Aged 15 to 69
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very
safe for most people. However, some people should check with their doctor before they start becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you
are between the ages of 15 and 69, the Physical Activity Readiness Questionnaire (PAR-Q) will tell you if you should check with your doctor
before you start. If you are over 69 years of age and you are not used to being very active, check with your doctor.
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check
YES or NO.
Save )
YES
NO
OJOJ
1. Has your doctor ever said that you have a heart condition and that you should only do physical
activity recommended by a doctor?
2. Do you feel pain in your chest when you do physical activity?
3. In the past month, have you had chest pain when you were not doing physical activity?
4. Do you lose your balance because of dizziness, or do you ever lose consciousness?
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse
by a change in your physical activity?
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or
heart condition?
7. Do you know of any other reason why you should not do physical activity?
if
YES to one or more questions
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a
fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.
you
You may be able to do any activity you want-as long as you start slowly and build up gradually. Or, you may need to
restrict your activities to those that are safe for you. Talk with your doctor about the kinds of activities you wish to
participate in and follow his/her advice.
answered Find out which community programs are safe and helpful for you.
NO to all questions
DELAY BECOMING MUCH MORE ACTIVE:
If you answered NO honestly to all PAR-Q questions, you can be
If you are not feeling well because of a temporary illness
reasonably sure that you can:
such as a cold or a fever-wait until you feel better, or
Start becoming much more physically active-begin slowly and
If you are or may be pregnant-talk to your doctor before
build up gradually. This is the safest and easiest way to go.
you start becoming more active
Take part in a fitness appraisal-this is an excellent way to
determine your basic fitness so that you can plan the best way
for you to live actively. It is also highly recommended that you
have your blood pressure evaluated. If your reading is over PLEASE NOTE: If your health changes so that you then answer YES to
144/94, talk with your doctor before you start becoming much any of the above questions, tell your fitness or health professional. Ask
more physically active.
whether you should change your physical activity plan.
Informed use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical
activity, and if in doubt after completion of this questionnaire, consult your doctor prior to physical activity
NOTE If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may be used for legal
or administrative purposes.
"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."
NAME:
SIGNATURE:
DATE:
SIGNATURE OF PARENT:
WITNESS:
or GUARDIAN (for participants under the age of majority)
NOTE: This physical activity clearance is valid for a maximum of 12 months form the date it is completed and
becomes Invalid If your condition changes so that you would answer YES to any of the seven questions.
IQ YN 0107
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If you have any questions on how to construct your answer please check our Sample Exam Answers page or contact our
Educational Support Team.
Section 1
Physical Activity Readiness Questionnaire
If you used this form, briefly summarize your findings and
how the findings will influence the nutrition program.
Section 2
Section
2002 imal Sport Resikon
S
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Medical History and Present Medical Condition Questionnaire
Page 1 of 3
Name
Date
In order for you to gain the most benefit from this program, we encourage you to answer all of the following questions. If you are uncomfortable
with answering a particular question, feel free to leave it blank. Please explain all YES answers at the end of this questionnaire.
PERSONAL MEDICAL HISTORY
Have you have ever had any of the following conditions?
YN
Y N
Y N
1. Allergies
11. Uker
21. Loss of consciousness
2. Loss of hearing
12. Heart attack
22. Epilepsy
3. Asthma
13. Heart murmur
23. Convulsions/seizures
4. Kidney disease
14. Positive stress test
24. Stroke
5. Prostatitis
15. Heart valve abnormality
25. Diabetes
6. Colitis
16. Angina
26. Thyroid trouble
7. Hepatitis
17. Heart failure
27. Anemia
8. Liver disease
18. High cholesterol
28. Eczema
9. Elevated liver enzyme test
19. High blood pressure
29. Cancer (including skin cancer)
10. Pancreatitis
20. Arthritis Rheumatism
30. Sleep apnea
REVIEW OF SYMPTOMS
Do you currently have or have you recently had any of the following?
EYES, EARS, NOSE, THROAT
PULMONARY
GENITO-URINARY
Y N
Y N
Y N
31. Difficulty with night vision
40. Shortness of breath
45. Bladder trouble
32. Change in vision
41. Chronic or frequent cough
46. Blood in urine
33. Blurred or double vision
42. Brown/Blood-tinged sputum
47. Irregular vaginal bleeding
34. Bleeding gums
43. Chest tightness
48. Currently pregnant
35. Frequent nosebleeds
44. Wheezing
49. Difficulty starting or stopping
urination
36. Frequent sinus trouble
37. Recent Hoarseness
50. Urinating 3 times per night
38. Ringing/Buzzing ears
51. Frequent or painful urination
39. Earaches
52. Problems with sexual function
GASTROINTESTINAL
CENTRAL NERVOUS SYSTEM
HEART/VASCULAR
Y N
Y N
Y N
53. Vomited blood
63. Fainting spells
71. Palpitation (irregular heartbeat)
54. Persistent diarrhea
64. Recurrent dizziness
72. Pain or discomfort in chest
55. Persistent constipation
65. Frequent headaches
73. High cholesterol
56. Frequent abdominal pain
66. Tremors
74. Swelling of feet
57. Frequent nausea
67. Memory loss
75. Leg pain while walking
58. Frequent indigestion/heartburn
68. Loss of coordination
76. Painful varicose veins
59. Black/Bloody bowel movement
69. Difficulty concentrating
60. Hemorrhoids
70. Numbness/Tingling extremities
61. Trouble swallowing
62. Hernia
MUSCULOSKELETAL.
MISCELLANEOUS
Y N
Y N
Y N
77. Back trouble/pain
81. Bleeding/Bruising easily
86. Night sweats
78. Neck trouble/pain
82. Enlarged glands
87. Undesired weight loss
79. Joint injury/pain/swelling
83. Rashes
88. Snoring
80. Carpal tunnel syndrome
84. Unexplained lumps
89. Difficulty sleeping
85. Chronic fatigue
90. Low blood sugar
Plane
ion of in der
indicate that
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serial with the
1. To conne
Elication below
call l. 192.692
0.100.7 0.1 inter
virul) non
atbed from this
mert a
with it
nible arabe
arteraria
man of the inlar
mation contain
orcella fronti
form. Alaps.com
our decor
in your healthier
பா piyialstris
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how the findings will influence the nutrition program.
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Review of symptoms:
do you currently have or have you recently had of the
following?
Section 1
Her answers no.
Section 2
Section
2002 alors Scenes ciaban
SA
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Comprehensive Client Information Sheet
Page 1 of 3
Name
Date
Instructions
This is your comprehensive client information sheet. With this sheet, we will ask you to provide some relevant personal informa-
tion. The answers to these questions are essential in order to allow us to design an optimized individual fitness program for you.
Please answer all questions in the most accurate manner possible while being as concise as possible.
Disclaimer
Please recognize the fact that it is your responsibility to work directly with your physician before, during, and after seeking
fitness consultation. As such, any information provided is not to be followed without the prior approval of your physician. If
you choose to use this information without the prior consent of your physician, you are agreeing to accept full responsibility
for your decision.
Basic Information
1) What is your gender? 2) What is your age?
3) What is your date of birth (month/day/year)?
4) What is your height?
5) What is your weight (measured as of this morning)?
6) What is your body fat percentage (have this taken before submitting this sheet)?
7) Please provide the following skinfold measures (mm).
8) Please provide the following girth measurements in or cm).
Abs
Subscapular
Neck
Chest
Triceps
Suprailiac
Shoulder
Biceps
Chest
Thigh
Waist
Hips
Mid-axillary
Calf
9) What are your specific goals (rank these goals according to importance with 1 being the most important and 8 being the least)?
Improved health
Improved endurance
Increased muscle mass
Fat loss
Increased strength
Sport specific
Increased power
Weight gain
*Please provide the sport or athletic event you are training for.
10) Is there a specific timeline for achieving a specific goal?
11) Circle which of the two are of greater importance:
a. Immediate progress that's less easily maintained b. Maintainable progress that may not be as rapid
Please explain:
Thigh
Novice
Unfamiliar
Exercise Information
12) Rate your ability in the following exercises (check the box that corresponds with your ability):
Exercises:
Advanced
Intermediate
Compound movements
Barbell squats
Barbell deadlift
Barbell bench press
Bent-over barbell row
Barbell Shoulder Press
Pull up
Barbell hack squat
Olympic movements
Snatch
Clean
13) Are you currently exercising regularly (at least 3x per week)? circle one
YES If you answered YES, continue on to question 14.
NO If you answer NO, continue on to question 18.
14) How long have you been consistently doing so without a break?
Planet
omofior does
indicate that its
berisik
cer with the
14. To conner
Escalante plee
call i. 192.672
0.100.76.11 inter
virul) nomion
wat from this
amira
with 15. But
nible erlab
forte carino
monof the inlar
main contain
or claren
Ascona
Murder
in your ball.de
ane picalacinity
CLOSE X
Ho Day Dictaly I
If you used this form, briefly summarize your findings and
how the findings will influence the nutrition program.
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Barbell Squats ( advanced).
Barbell deadlift (Novice).
Section 1
Barbell bench press (intermediate).
Section 2
Section
2002 imalories xiakan
SA
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Three-Day Dietary Record
Page 1 of 4
Name
Date
It is important that this record be both accurate and representative of your normal dietary intake.
Consequently, it is essential that you do not alter your normal eating habits in any way and that you
record as precisely as possible every single item that you consume (this includes water, vitamins, condi-
ments, margarine, etc). To do so, you must follow a few simple instructions (listed below). The purpose
here is to quantify your normal intake so do not alter your eating habits in any way or the resulting
analysis, although accurate, will be useless because it will not be representative of your typical diet. The
procedure may seem somewhat cumbersome, but remember, it is only 3 days.
Instructions
1. Keep a pen and paper with you at all times to record your intake including food item, quantity,
and notes. This is imperative as snacks are typically consumed unpredictably and, as a result, it is
impossible to record them accurately unless your recording forms are nearby.
2. Use a small food scale if you have one or use standard measuring devices (e.g., measuring cups,
measuring spoons) to record the quantities consumed, as accurately as possible. If you do not eat
all of the item (for instance a portion of an apparently delicious hastily prepared casserole of left-
overs that turned out to be not so delicious), re-measure what's left and record the difference.
3. Record combination foods separately (i.e., hot dog, bun, and condiments) and include brand
names of food items (list contents of homemade items) whenever possible.
4. For packaged items, use labels to determine quantities.
5. Record 3 days that are representative of your normal intake. Therefore if your weekdays are differ-
ent from your weekends, pick two weekdays and one weekend. Likewise, if your M, W, and F are
different from your T and Th and all these days are different from your Sat and Sun, you should
pick one day to represent each unique schedule.
Sample Dietary Record, Day 1
Food Item
Quantity
(include brand name)
(g, ml, tablespoons [U],
teaspoons [t] cups (c), etc)
Notes
(include ingredients and
amounts of homemade items)
2 pcs
Breakfast
2 pieces toast
Margarine
Orange Juice
it
6 03
Lunch
Small pizza
400 g
pepperoni, mushroom, cheese
Flere
inofilon dees
indicate that
berish
erial with the
B1. To conne
Ebatan plane
call i. 192.02
0.100.7 0.
ularul) traion
the frons
omista
wi Hist
nible erlable
for the corner
perabonelikler
main contain
Dinner
Chicken
603
Baked Potato
6 07
Mixed Vegetables
10
peas, carrots, corn
form. Alvar.com
waarderen
in our bath, diet
and physical fins
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tea
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Butter on bread
1 table spoon
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Food item
quantity
Notes
Dashboard
Breakfast
Coffee
large
Section 1
sugar
2 table spoon regularly
Section 2.
Section
herriealorisereniton
SA
1015 Mark Avenue. Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Readiness for Change Questionnaire
Page 1 of 2
One of the most important things you can do to change your lifestyle for the better is this: understand your
readiness for change. In other words, although you might want to be in great shape, there's a difference
between wanting it and being ready to do the work necessary to accomplish it. In this questionnaire we'll find
out if you're really ready to make the changes necessary to improve your body composition, health, and physi-
cal performance
Simply answer the questions to follow by selecting the response most appropriate to your situation. Once you've
completed all the questions, your score will be calculated. And remember, be honest. You're doing this exercise
to find out if you're really ready to make a lifestyle change. So, don't lie to yourself.
Questions
Responses and Scoring
1. Do you look the mirror and get frustrated,
upset, or humiliated because of how your body
looks?
a) Yes (+3)
b) I'm Not Sure (0)
c) No (-3)
2. When you feel run down and tired, do you blame
these feelings on "getting older" or do you blame
them on your lifestyle habits?
a) I blame it on getting older (-1)
b) i blame it on my lifestyle choices (+3)
c) I blame it on something else altogether (-3)
3. Are you taking any medications for heart disease,
high blood pressure, or type Il diabetes that you
didn't have to take when you were younger?
a) Yes, I'm on a number of these medications (+3)
b) Yes, I'm on only one of these medications (+1)
c) No, I'm not on any of these medications (-3)
4. How do you explain the fact that you're in worse
shape than when you were younger but haven't
changed your habits at all?
a) I think it's my family history (-1)
b) I think it's that I'm less active (+3)
c) I think it's a natural consequence of aging (-1)
d) I don't know why it's happening (0)
5. If you don't have anyone to exercise with regularly, a) Yes (+5)
are you willing to look for a physical activity part- b) No (-5)
ner?
6. Are you willing to join a gym today?
a) Yes (+3)
b) No (-3)
7. If someone told you that you'd need to throw a) Yes (+5)
away all the foods in your cupboards today and go b) No (-5)
shopping for different foods, foods more appropri-
ate to your goal, would you do it?
8. If an expert presents some information on diet and a) Keep an open mind and give it a try (+3)
exercise that contradicts what you currently b) Ask a friend (0)
believe, what approach will you take?
c) Ignore the advice (-3)
Place
inofilom does
indicate that its
brisach
er with the
14. To conner
taientisples
call i. 192.02
0.100.10111iner
steal) மruian
water from this
பாாபctual
wit. But
ble erlable
for the correr
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main contain
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Ascona
de TORRENT
in our balldier
and physicalacinis
9. Are you willing to have a meeting with your
friends and loved ones and share with them your
behavior goals and desired outcomes?
a) Yes, right away (+5)
b) Yes, but not just yet (-3)
c) No (-5)
CLOSE X
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If you have any questions on how to construct your answer please check our Sample Exam Answers page or contact our
Educational Support Team.
Section 1
Physical Activity Readiness Questionnaire
If you used this form, briefly summarize your findings and
how the findings will influence the nutrition program.
Section 2
Section
2002 imal Sport Resikon
S
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Medical History and Present Medical Condition Questionnaire
Page 1 of 3
Name
Date
In order for you to gain the most benefit from this program, we encourage you to answer all of the following questions. If you are uncomfortable
with answering a particular question, feel free to leave it blank. Please explain all YES answers at the end of this questionnaire.
PERSONAL MEDICAL HISTORY
Have you have ever had any of the following conditions?
YN
Y N
Y N
1. Allergies
11. Uker
21. Loss of consciousness
2. Loss of hearing
12. Heart attack
22. Epilepsy
3. Asthma
13. Heart murmur
23. Convulsions/seizures
4. Kidney disease
14. Positive stress test
24. Stroke
5. Prostatitis
15. Heart valve abnormality
25. Diabetes
6. Colitis
16. Angina
26. Thyroid trouble
7. Hepatitis
17. Heart failure
27. Anemia
8. Liver disease
18. High cholesterol
28. Eczema
9. Elevated liver enzyme test
19. High blood pressure
29. Cancer (including skin cancer)
10. Pancreatitis
20. Arthritis Rheumatism
30. Sleep apnea
REVIEW OF SYMPTOMS
Do you currently have or have you recently had any of the following?
EYES, EARS, NOSE, THROAT
PULMONARY
GENITO-URINARY
Y N
Y N
Y N
31. Difficulty with night vision
40. Shortness of breath
45. Bladder trouble
32. Change in vision
41. Chronic or frequent cough
46. Blood in urine
33. Blurred or double vision
42. Brown/Blood-tinged sputum
47. Irregular vaginal bleeding
34. Bleeding gums
43. Chest tightness
48. Currently pregnant
35. Frequent nosebleeds
44. Wheezing
49. Difficulty starting or stopping
urination
36. Frequent sinus trouble
37. Recent Hoarseness
50. Urinating 3 times per night
38. Ringing/Buzzing ears
51. Frequent or painful urination
39. Earaches
52. Problems with sexual function
GASTROINTESTINAL
CENTRAL NERVOUS SYSTEM
HEART/VASCULAR
Y N
Y N
Y N
53. Vomited blood
63. Fainting spells
71. Palpitation (irregular heartbeat)
54. Persistent diarrhea
64. Recurrent dizziness
72. Pain or discomfort in chest
55. Persistent constipation
65. Frequent headaches
73. High cholesterol
56. Frequent abdominal pain
66. Tremors
74. Swelling of feet
57. Frequent nausea
67. Memory loss
75. Leg pain while walking
58. Frequent indigestion/heartburn
68. Loss of coordination
76. Painful varicose veins
59. Black/Bloody bowel movement
69. Difficulty concentrating
60. Hemorrhoids
70. Numbness/Tingling extremities
61. Trouble swallowing
62. Hernia
MUSCULOSKELETAL.
MISCELLANEOUS
Y N
Y N
Y N
77. Back trouble/pain
81. Bleeding/Bruising easily
86. Night sweats
78. Neck trouble/pain
82. Enlarged glands
87. Undesired weight loss
79. Joint injury/pain/swelling
83. Rashes
88. Snoring
80. Carpal tunnel syndrome
84. Unexplained lumps
89. Difficulty sleeping
85. Chronic fatigue
90. Low blood sugar
Plane
ion of in der
indicate that
berish
serial with the
1. To conne
Elication below
call l. 192.692
0.100.7 0.1 inter
virul) non
atbed from this
mert a
with it
nible arabe
arteraria
man of the inlar
mation contain
orcella fronti
form. Alaps.com
our decor
in your healthier
பா piyialstris
CLOSE X
Exam Status | Top of Page
how the findings will influence the nutrition program.
iPad
10:59 PM
52%
Dashboard
Review of symptoms:
do you currently have or have you recently had of the
following?
Section 1
Her answers no.
Section 2
Section
2002 alors Scenes ciaban
SA
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Comprehensive Client Information Sheet
Page 1 of 3
Name
Date
Instructions
This is your comprehensive client information sheet. With this sheet, we will ask you to provide some relevant personal informa-
tion. The answers to these questions are essential in order to allow us to design an optimized individual fitness program for you.
Please answer all questions in the most accurate manner possible while being as concise as possible.
Disclaimer
Please recognize the fact that it is your responsibility to work directly with your physician before, during, and after seeking
fitness consultation. As such, any information provided is not to be followed without the prior approval of your physician. If
you choose to use this information without the prior consent of your physician, you are agreeing to accept full responsibility
for your decision.
Basic Information
1) What is your gender? 2) What is your age?
3) What is your date of birth (month/day/year)?
4) What is your height?
5) What is your weight (measured as of this morning)?
6) What is your body fat percentage (have this taken before submitting this sheet)?
7) Please provide the following skinfold measures (mm).
8) Please provide the following girth measurements in or cm).
Abs
Subscapular
Neck
Chest
Triceps
Suprailiac
Shoulder
Biceps
Chest
Thigh
Waist
Hips
Mid-axillary
Calf
9) What are your specific goals (rank these goals according to importance with 1 being the most important and 8 being the least)?
Improved health
Improved endurance
Increased muscle mass
Fat loss
Increased strength
Sport specific
Increased power
Weight gain
*Please provide the sport or athletic event you are training for.
10) Is there a specific timeline for achieving a specific goal?
11) Circle which of the two are of greater importance:
a. Immediate progress that's less easily maintained b. Maintainable progress that may not be as rapid
Please explain:
Thigh
Novice
Unfamiliar
Exercise Information
12) Rate your ability in the following exercises (check the box that corresponds with your ability):
Exercises:
Advanced
Intermediate
Compound movements
Barbell squats
Barbell deadlift
Barbell bench press
Bent-over barbell row
Barbell Shoulder Press
Pull up
Barbell hack squat
Olympic movements
Snatch
Clean
13) Are you currently exercising regularly (at least 3x per week)? circle one
YES If you answered YES, continue on to question 14.
NO If you answer NO, continue on to question 18.
14) How long have you been consistently doing so without a break?
Planet
omofior does
indicate that its
berisik
cer with the
14. To conner
Escalante plee
call i. 192.672
0.100.76.11 inter
virul) nomion
wat from this
amira
with 15. But
nible erlab
forte carino
monof the inlar
main contain
or claren
Ascona
Murder
in your ball.de
ane picalacinity
CLOSE X
Ho Day Dictaly I
If you used this form, briefly summarize your findings and
how the findings will influence the nutrition program.
Exam Status | Top of Page
iPad
11:00 PM
52%
Food item
quantity
Notes
Dashboard
Breakfast
Coffee
large
Section 1
sugar
2 table spoon regularly
Section 2.
Section
herriealorisereniton
SA
1015 Mark Avenue. Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Readiness for Change Questionnaire
Page 1 of 2
One of the most important things you can do to change your lifestyle for the better is this: understand your
readiness for change. In other words, although you might want to be in great shape, there's a difference
between wanting it and being ready to do the work necessary to accomplish it. In this questionnaire we'll find
out if you're really ready to make the changes necessary to improve your body composition, health, and physi-
cal performance
Simply answer the questions to follow by selecting the response most appropriate to your situation. Once you've
completed all the questions, your score will be calculated. And remember, be honest. You're doing this exercise
to find out if you're really ready to make a lifestyle change. So, don't lie to yourself.
Questions
Responses and Scoring
1. Do you look the mirror and get frustrated,
upset, or humiliated because of how your body
looks?
a) Yes (+3)
b) I'm Not Sure (0)
c) No (-3)
2. When you feel run down and tired, do you blame
these feelings on "getting older" or do you blame
them on your lifestyle habits?
a) I blame it on getting older (-1)
b) i blame it on my lifestyle choices (+3)
c) I blame it on something else altogether (-3)
3. Are you taking any medications for heart disease,
high blood pressure, or type Il diabetes that you
didn't have to take when you were younger?
a) Yes, I'm on a number of these medications (+3)
b) Yes, I'm on only one of these medications (+1)
c) No, I'm not on any of these medications (-3)
4. How do you explain the fact that you're in worse
shape than when you were younger but haven't
changed your habits at all?
a) I think it's my family history (-1)
b) I think it's that I'm less active (+3)
c) I think it's a natural consequence of aging (-1)
d) I don't know why it's happening (0)
5. If you don't have anyone to exercise with regularly, a) Yes (+5)
are you willing to look for a physical activity part- b) No (-5)
ner?
6. Are you willing to join a gym today?
a) Yes (+3)
b) No (-3)
7. If someone told you that you'd need to throw a) Yes (+5)
away all the foods in your cupboards today and go b) No (-5)
shopping for different foods, foods more appropri-
ate to your goal, would you do it?
8. If an expert presents some information on diet and a) Keep an open mind and give it a try (+3)
exercise that contradicts what you currently b) Ask a friend (0)
believe, what approach will you take?
c) Ignore the advice (-3)
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9. Are you willing to have a meeting with your
friends and loved ones and share with them your
behavior goals and desired outcomes?
a) Yes, right away (+5)
b) Yes, but not just yet (-3)
c) No (-5)
CLOSE X
Exam Status | Top of Page
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52%
Paragraph
А
В І О
Dashboard
를 들를
I
Section 1
1- Yes(+3).
Section 2.
LITLI
---
1:
Emble haien
orm
Section
2009 Resporteresation
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Save
Kitchen Makeover Questionnaire
Page 1 of 2
There's a fundamental law of human nutrition that goes like this: if a food is in your possession or located in your
residence, you will eventually eat it. (Whether you plan to or not, whether you want to or not, you'll eventually
eat it!) Therefore, according to this important law of human nutrition, if you wish to be healthy and lean, you
must remove all foods that aren't part of your healthy eating program and replace them with a variety of better,
healthier choices.
So how do you know which foods have got to go and which foods can stay? Simply answer the questions to fol-
low by selecting the response most appropriate to your situation. Once you've completed all the questions, your
score will be calculated. And remember, be honest. You're doing this exercise to find out whether or not your
kitchen is in good shape.
Questions
Responses and Scoring
1. Do you have the following items in your kitchen?
a) I have all of them. (-5)
b) I have more than half of them. (-2)
* Good set of pots and pans * Scale for weighing foods
c) I have less than half of them. (+2)
* Good set of knives
* Sealable containers for carrying meals d) I don't have any of them. (+5)
* Spatula
* Small cooler for taking meals to work
* Blender
* Shaker bottle for drinks and shakes
* Tea kettle
* Food processor
a) I have all of them. (-5)
b) I have more than half of them. (-2)
c) I have less than half of them. (+2)
d) I don't have any of them. (+5)
2. Do you have the following items in your pantry?
* Whole oats
* Extra virgin olive oil
* Quinoa
* Vinegar
* Whole grain pasta
* Green tea
* Natural peanut butter * Protein supplements
* Mixed nuts
* Fish oil supplements
* Canned or bagged beans * Green foods supplements
3. Do you have the following items in your fridge or freezer?
* Extra-lean beef
* At least four varieties of fruit
* Chicken breasts
* At least five varieties of vegetables
* Salmon
* Flax seed oil
* Omega 3 eggs
* Water filter
* Packaged egg whites Sweet potatoes
* Real cheese
a) I have all of them. (-5)
b) I have more than half of them.(-2)
c) I have less than half of them. (+2)
d) I don't have any of them. (+5)
a) I have all of them. (+5)
b) I have more than half of them. (+2)
c) I have less than half of them. (-2)
d) I don't have any of them. (-5)
4. Do you have the following items in your pantry?
* Potato or corn chips * Chocolates or candy
* Fruit or granola bars * Soft drinks
* Regular or low-fat cookies * Crackers
* Regular peanut butter * At least 4 types of alcohol
* Instant foods like cake mixes and mashed potatoes
* Bread crumbs, croutons, and other dried bread products
5. Do you have the following items in your fridge or freezer?
* At least 4 types of sauces
* Margarine
* Juicy steaks or sau sage
* Fruit Juice
* At least 2 types of breads or bagels * Soft drinks
* Take-out or restaurant leftovers
* Baked goods
* Big bowl of mashed potatoes or pasta * Frozen dinners
6. Do you have bowls of candy, chips, crackers, or other snacks sitting
around at home?
a) I have all of them. (+5)
b) I have half or more than half of
them. (+2)
c) I have less than half of them. (-2)
d) I don't have any of them.(-5)
le
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in your health, dict,
and physical activity
a) Yes (+5)
b) No (-5)
CLOSE X
3- aj res it is easy iu imu a partner (2).
Exam Status Top of Page
4. hyes but very infrequently
iPad
11:02 PM
52%
Suprallac skin fold
11
Hip girth
91
Dashboard
Thigh skinfold
13
Thigh girth
41.5
Section 1
Calf girth
23
Sum of mean skinfolds in mm= body fat %=14
Section 2.
Section
2002 finalors cresciation
1015 Mark Avenue . Carpinteria, CA 93013
1.800.892.4772 (toll-free). 1.805.745.8111 (international)
www.ISSAonline.edu
International Sports Sciences Association
Saved at 11
Save
Initial Recovery Assessment
Page 1 of 1
Rate the following mood qualities on a scale of 0 to 5 as follows:
Appetite: O=No Appetite 5=Very hungry
Sleep quality: O=Poor sleep 5=Very good sleep
Tiredness: O=No tiredness 5=Very tired
Willingness to train: 0=No willingness 5=Very excited to train
Mood quality
Rating (0-5)
Appetite
Sleep quality
Tiredness
Willingness to train
Record your resting heart rate (taken first thing in the morning while seated, not standing) below.
Place your index and middle finger on either your carotid artery (neck) or your radial artery (inside of
your wrist) and count the number of beats you feel in 60 seconds.
Planer
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Resting morning heart rate
(beats/minute)
ponible erlable
fare scaricar
perfonafteinar
main contain
or called for this
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in our ball, der
are payecalactis
CLOSE X
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barbell snatch
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