Faculty/Staff Bluehealth Rewards Fitness Assessment Request Form
Name:
*
First Name
Last Name
E-mail:
*
Phone Number:
*
-
Area Code
Phone Number
When did you last have a fitness assessment done by FitRec?
How satisfied are you with the current amount of physical activity you do per week?
Very Satisfied
Satisfied
Somewhat Dissatisfied
Completely Dissatisfied
Submit
Should be Empty: