International Sports Sciences Association
Confidentiality Agreement
This form is adapted from ISSA client assessment materials
PLEASE READ THE BELOW STATEMENT AND SIGN WHERE INDICATED.
I, ________________________________________________ understand that the information collected by
Name of Business
________________________________________________ will be used for fitness evaluation purposes and for the design, implementation, progression, and maintenance of an individualized fitness program only. I further understand that all such information is confidential and will not be shared with anyone without my prior written authorization, except in the case of a medical emergency or to the minimum extent necessary to achieve a safe and effective fitness program.
NAME:
SIGNATURE:
DATE:
-
Month
-
Day
Year
Date
SIGNATURE OF PARENT: or GUARDIAN (for participants under the age of majority)
WITNESS:
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