Fitness Assessment
Name:________________________________________________Date:__________________________
Personal Goal I want to meet over the next 3 months:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Result
Rating Category
Weight
Body Fat Percentage
Blood Pressure
3 Minute Step Test
Push-ups/Modified Push-ups
Leg Strength-Wall Squat
Ab Plank
Sit and Reach Test
Zipper Test
Descriptions and Directions:
Weight
Weight in pounds:________________
Body Fat Percentage
Body fat percentage is simply the percentage of fat that your body contains. A high body fat percentage puts you at risk
for Type 2 diabetes, high blood pressure, high cholesterol, and heart disease. An overweight or obese body fat reading
means you need to lose weight. Using a bioelectrical impedance analysis (BIA), you can see your current body fat
percentage. The BIA sends a harmless electrical current through your body and measures the amount of fluids you
contain in your fat free mass (fat mass is incapable of carrying an electrical current). BIAs are accurate within about 3 to
5%.
Men
Rating
Athlete (well above average)
Lean (above average)
Average
Overweight (below average)
Obese (well below average)
20-29
7.1-11.7
11.8-15.8
15.9-19.4
19.5-25.8
25.9+
30-39
11.3-15.8
15.9-18.9
19-22.2
22.3-27.2
27.3+
Age
40-49
13.6-18
18.1-21
21.1-24
21.4-28.8
28.9+
50-50
15.3-19.7
19.8-22.6
22.7-25.6
25.7-30.2
30.3+
60+
15.3-20.7
20.8-23.4
23.5-26.6
26.7-31.1
31.2+
Women
Rating
Athlete (well above average)
Lean (above average)
Average
Overweight (below average)
Obese (well below average)
20-29
14.5-18.9
19-22
22.1-25.3
25.4-32
32.1+
30-39
15.5-19.9
20-23
23.1-26.9
27-32.7
32.8+
Age
40-49
18.5-23.4
23.5-26.3
26.4-30
30.1-34.9
35+
50-50
21.6-26.5
26.6-30
30.1-33.4
33.5-37.8
37.9+
60+
21.1-27.4
27.5-30.8
30.9-34.2
34.2-39.2
39.3+
Blood Pressure
Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in
your arteries. Uncontrolled high blood pressure (or hypertension) increases your risk of numerous serious health
problems, including heart attack and stroke. Blood pressure can be controlled with lifestyle changes (diet and exercise)
and/or medication.
Rating
Normal
Prehypertension
Hypertension
Top number (systolic)
Below 120
120-139
140-159
Bottom number (diastolic)
Below 80
80-89
90-99
3-Minute Step Test
Set a metronome to 96 beats per minutes and make sure you can hear the beat. Stand facing a 12 inch step. When
ready, start the clock and march up and down the step to the metronome beat (up, up, down, down) for 3 minutes. You
can rest if you need to, but remain standing. When 3 minutes are up, stop immediately, sit down on the step and count
your pulse for one full minute.
Men
Rating /Age
Excellent
Good
Above Average
Average
Below Average
Poor
Very Poor
18-25
<79
79-89
90-99
100-105
106-116
117-128
>128
26-35
<81
81-89
90-99
100-107
108-117
118-128
>128
36-45
<83
83-96
97-103
104-112
113-119
120-130
>130
46-55
<87
87-97
98-105
106-116
117-122
123-132
>132
56-65
<86
86-97
98-103
104-112
113-120
121-129
>129
65+
<88
88-96
97-103
104-113
114-120
121-130
>130
Women
Rating /Age
Excellent
Good
Above Average
Average
Below Average
Poor
Very Poor
18-25
<85
85-98
99-108
109-117
118-126
127-140
>140
26-35
<88
88-99
100-111
112-119
120-126
127-138
>138
36-45
<90
90-102
103-110
111-118
119-128
129-140
>140
46-55
<94
94-104
105-115
116-120
121-126
127-135
>135
56-65
<95
95-104
105-112
113-118
119-128
129-139
>139
65+
<90
90-102
103-115
116-122
123-128
129-134
>134
Sit and Reach Test
The sit-and-reach test is used to assess flexibility in the hamstrings, hips, and lower back.
 Remove your shoes and sit on the floor with the yardstick between the legs (feet at the zero mark), with your
feet about 12 inches apart.


With the fingertips in contact with the yardstick, slowly stretch forward with both hands as far as possible noting
where the fingertips are to the closest inch. Do not use fast and sudden motions, which can injure your
hamstring muscles.
Perform the stretch three times and record the best measurement.
Rating (in inches)
Excellent
Good
Average
Fair
Poor
Women
8+
4.5 to 7.5
.5 to 4
-2.5 to .45
-3>
Men
6.5+
2.5 to 6
0 to 2
-3 to .5
-3.5>
Zipper Test
The shoulder stretch (also called the zipper) is used to assess flexibility in the shoulders.
 Start with the right shoulder.
 Reach over your right shoulder with your right hand arm. Reach as far down your back as you can (pretend you
are reaching for a zipper on your back or that you are going to scratch between your shoulder blades).
 Reach behind the low back with the left arm and try to reach up and touch your right hand. Reach as far as you
can with both hands, trying to overlap your hands if possible.
 Repeat with the left shoulder.
Rating
Excellent
Good
Average
Poor
Fingers overlap
Fingers touch
Fingers are less than 2 inches apart
Fingers are more than 2 inches apart
Push-ups/Modified Push-ups
Do as many push-ups as possible consecutively. A push-up only counts when elbows bent at a 90 degree angle or more.
When form breaks or you are too tired to continue, the test is complete. Full push-ups legs extended; modified pushups on your knees; must select only one push-up format.
Men
Age: 18-29
30-39
40-49
50-59
60 & over
Superior
Above 61
Above 51
Above 39
Above 38
Above 27
Excellent
47-61
39-51
30-39
25-38
23-27
Good
37-46
30-38
24-29
19-24
18-22
Fair
29-36
24-29
18-23
13-18
10-17
Poor
22-28
17-23
11-17
9-12
6-9
Very Poor
Below 22
Below 17
Below 11
Below 9
Below 6
Women
Age: 18-29
30-39
40-49
50-59
60 & over
Superior
Above 44
Above 38
Above 32
Above 27
Above 19
Excellent
36-44
31-38
24-32
21-27
15-19
Good
30-35
24-30
18-23
17-20
12-14
Fair
23-29
19-23
13-17
12-16
5-11
Poor
17-22
11-18
6-12
6-11
2-4
Very Poor
Below 17
Below 11
Below 6
Below 6
Below 2
Leg Strength—Wall Squat
Stand with back against the wall, feet out from wall; squat until knees are bent at a 90 degree angle from the wall. Hold
for as long as possible.
Rating /Age
Excellent
Good
Above Average
Average
Below Average
Poor
Very Poor
18-25
>49
44-49
39-43
35-38
31-34
25-30
<25
Men
26-35 36-45
>45
>41
40-45 35-41
35-39 30-34
31-34 27-29
29-30 23-26
22-28 17-22
<22
<17
46-55
>35
29-35
25-28
22-24
18-21
13-17
>9
56-65
>31
25-31
21-24
17-20
13-16
9-12
<9
65+
>28
22-28
19-21
15-18
11-14
7-10
<7
Rating /Age
Excellent
Good
Above Average
Average
Below Average
Poor
Very Poor
18-25
>43
37-43
33-36
29-32
25-28
18-24
<18
Women
26-35 36-45
>39
>33
39-47 27-33
29-32 23-26
25-28 19-22
21-24 15-18
13-20
7-14
<20
<7
46-55
>27
22-27
18-21
14-17
10-13
5-9
<5
56-65
>24
18-24
13-17
10-12
7-9
3-6
<3
65+
>23
17-23
14-16
11-13
5-10
2-4
<2
Ab Plank
Hold a full plank (on elbows position, modification: on knees) for long as possible before form breaks or you are too tired
to continue.
Rating
Excellent
Good
Average
Fair
Poor
Women
>90 seconds
61-90 seconds
31-60 seconds
16-30 seconds
0-15 seconds
Men
>120 seconds
91-120 seconds
61-90 seconds
31-60 seconds
0-30 seconds