ReadyFit Assessment Form

ReadyFit Assessment Form

Oklahoma State University
ReadyFit is a one-time, non-committal personal training assessment offered through the Department of Wellness. This session includes a body composition scan, functional movement screening, and basic health and fitness evaluation.

DISCLAIMER: A NO-CALL, NO-SHOW TO A SCHEDULED APPOINTMENT MAY RESULT IN A $55 CHARGE TO YOUR BURSAR ACCOUNT. If you are unable to attend, please email Mitch Swensen @ mitch.swensen@okstate.edu
Personal Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Age*
Gender
Appointment*
Have you completed payment?*

YesNo
Website: https://rec.wellness.okstate.edu/MultiVisitPass/GetMultiVisitPassDetails?pass=d472d0bf-5a30-4716-a0cb-c84ef778034b
Health and Fitness Information
Describe your current level of physical activity?*
What are your fitness goals?*
What information are you hoping to obtain from this visit?*
Has your doctor ever said that you have a heart condition OR high blood pressure?

YesNoUnknown
Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?

YesNoUnknown
Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise).

YesNoUnknown
Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?

YesNoUnknown
Are you currently taking prescribed medications for a chronic medical condition?

YesNoUnknown
Do you have a bone or joint problem (within the last 12 months) that could be made worse by becoming more physically active?

YesNoUnknown
Has your doctor ever said that you should only do medically supervised physical activity?

YesNoUnknown
Do you have a medical condition that is not listed (such as epilepsy, neurological conditions, kidney problems)

YesNoUnknown
If you answered "yes" to any of the questions above, please describe in concise detail:
Are you interested in personal training here at the OSU Department of Wellness?

YesNoUnknown
Waiver
Voluntary Participation & Assumption of Risk:
I understand that participation in the ReadyFit assessment is entirely voluntary. I acknowledge that, as with any physical activity, there are inherent risks of injury. I agree to assume full responsibility for any risks, injuries, or damages known or unknown that might arise as a result of my participation in this session.

Confidentiality of Personal Information:
I understand that this assessment may involve the collection of sensitive personal and health-related information. I acknowledge that all such data will be stored securely and protected by password-access only. This information will not be shared without my explicit consent, unless required by law.

Disclaimer of Ongoing Obligation:
I acknowledge that ReadyFit is a standalone session and does not imply an ongoing personal training relationship. Should I choose to continue with further services, I understand that additional waivers and agreements may be required.

By signing below, I confirm that I have read and understand the above information, and I agree to participate in the ReadyFit session under these terms.
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Emergency Contact Phone
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ReadyFit Assessment Form

Personal Information

Health and Fitness Information

Waiver