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History and Intake Form Name ___, ___ Last FirstTodays Date ___Your Height ___Your Weight___(pounds)Did you get a flu shot this season? Have you had a shingles shot? Yes___ No___ Yes___ No___If you
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How to fill out fitness-for-life program medical history

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How to fill out fitness-for-life program medical history

01
Obtain the medical history form from the fitness-for-life program coordinator.
02
Fill out personal information including name, contact information, and date of birth.
03
Provide detailed information about any medical conditions or previous injuries.
04
List any medications that are currently being taken.
05
Include emergency contact information.
06
Sign and date the form before submitting it to the program coordinator.

Who needs fitness-for-life program medical history?

01
Individuals who are participating in the fitness-for-life program.
02
Anyone with pre-existing medical conditions or injuries that may impact their ability to exercise safely.
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The fitness-for-life program medical history is a document that collects an individual's health and medical background to assess their suitability for participation in physical fitness programs.
Participants in the fitness-for-life program, including students, athletes, and others engaging in specific health and fitness activities, are required to file their medical history.
To fill out the fitness-for-life program medical history, individuals should provide accurate and complete information regarding their past medical conditions, surgeries, medications, allergies, and family health history.
The purpose of fitness-for-life program medical history is to ensure the safety of participants, identify any health risks, and tailor fitness programs to meet the individual’s health needs.
The information that must be reported includes personal identification details, medical conditions, past surgeries, medication usage, allergies, and any relevant family medical history.
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