Informed Consent
1. Purpose and Explanation – Your Medical-Fitness Assessment includes standardized fitness tests that are conducted by a certified Medical-Fitness Technician to ensure safety and accuracy. You will be asked to perform a series of basic exercises with the objective to determine your physical functional capacity. Your results will help generate an appropriate exercise prescription. This will also give you the option to track your progress towards your personal fitness goals by periodically repeating the same exercise tests every few months depending on your fitness level and training program.
2. Instructions – You are allowed to modify each exercise to the best of your ability and to set your own pace to whatever intensity level is comfortable for you. You may stop any exercise test at any time for any reason. Your Medical-Fitness Technician may encourage you to slow-down, or may even insist that you stop, depending on the signs of exertion or discomfort that you exhibit during your exercise test.
3. Attendant Discomforts and Risks – There is the possibility of certain physiological changes occurring during your exercise tests. These include shortness of breath, pounding heart beats, palpitations, dizziness, fatigue, impaired coordination, and in extremely rare instances, heart attack, stroke, or death.
4. Your Responsibilities – It is important for you to have answered the screening questions accurately regarding any pre-existing heart-related symptoms, your medical history, and your current pattern of physical activity. You are fully responsible for disclosing all symptoms that you experience during your exercise tests, such as pain, shortness of breath, or pressure, tightness, and/or heaviness in your chest, neck, jaw, back, and/or arms.
5. Benefits to Be Expected – Upon completing your Medical-Fitness Assessment, you will obtain an accurate Fitness Score and an appropriate Exercise Rx. Your Fitness Score reflects: a) Your functional capacity, and during follow-up, b) The effectiveness of your exercise program, and c) Your progress towards your fitness goal. Aggregate data will be used for the advancement of exercise science and lifestyle therapies. If applicable, your doctor may use your Fitness Score to better manage any sedentary-related condition you may have in conjunction with your on-going medical treatment.
6. Inquiries – You are encouraged to get any desired clarifications regarding your Medical-Fitness Assessment and Therapeutic Fitness Training. If you or your doctor, physical therapist, coach, or personal trainer have any questions or concerns regarding the procedures, results, or potential health benefits of regular exercise, please contact:
2. Instructions – You are allowed to modify each exercise to the best of your ability and to set your own pace to whatever intensity level is comfortable for you. You may stop any exercise test at any time for any reason. Your Medical-Fitness Technician may encourage you to slow-down, or may even insist that you stop, depending on the signs of exertion or discomfort that you exhibit during your exercise test.
3. Attendant Discomforts and Risks – There is the possibility of certain physiological changes occurring during your exercise tests. These include shortness of breath, pounding heart beats, palpitations, dizziness, fatigue, impaired coordination, and in extremely rare instances, heart attack, stroke, or death.
4. Your Responsibilities – It is important for you to have answered the screening questions accurately regarding any pre-existing heart-related symptoms, your medical history, and your current pattern of physical activity. You are fully responsible for disclosing all symptoms that you experience during your exercise tests, such as pain, shortness of breath, or pressure, tightness, and/or heaviness in your chest, neck, jaw, back, and/or arms.
5. Benefits to Be Expected – Upon completing your Medical-Fitness Assessment, you will obtain an accurate Fitness Score and an appropriate Exercise Rx. Your Fitness Score reflects: a) Your functional capacity, and during follow-up, b) The effectiveness of your exercise program, and c) Your progress towards your fitness goal. Aggregate data will be used for the advancement of exercise science and lifestyle therapies. If applicable, your doctor may use your Fitness Score to better manage any sedentary-related condition you may have in conjunction with your on-going medical treatment.
6. Inquiries – You are encouraged to get any desired clarifications regarding your Medical-Fitness Assessment and Therapeutic Fitness Training. If you or your doctor, physical therapist, coach, or personal trainer have any questions or concerns regarding the procedures, results, or potential health benefits of regular exercise, please contact:
Name of Technician, MFT
Tech's Email
Tech's Email
7. Use of Personal Information – The information that is obtained during your Medical-Fitness Assessment will be treated as privileged and confidential. It will not be released or revealed to any third party. Aggregate information will be used for statistical analysis and scientific research purposes while fully protecting your identity and right to privacy. Of course, you are always free to share your Medical-Fitness Score and Therapeutic Fitness Training experience with anyone you choose to do so.
8. Freedom of Consent – Your voluntary participation in a Medical-Fitness Assessment and/or Therapeutic Fitness Training acknowledges that you have read this Informed Consent and accept the attendant discomforts and risks. You understand: a) The nature of the procedures and exercises, b) That you are free to stop your exercise tests at any time, and c) That you had the opportunity to ask questions and get answers to your satisfaction. If you have any health or medical concerns that cannot be adequately addressed by your Med-Fit Tech, you should speak with your personal physician about sub-maximal fitness testing and light-moderate therapeutic exercise.
8. Freedom of Consent – Your voluntary participation in a Medical-Fitness Assessment and/or Therapeutic Fitness Training acknowledges that you have read this Informed Consent and accept the attendant discomforts and risks. You understand: a) The nature of the procedures and exercises, b) That you are free to stop your exercise tests at any time, and c) That you had the opportunity to ask questions and get answers to your satisfaction. If you have any health or medical concerns that cannot be adequately addressed by your Med-Fit Tech, you should speak with your personal physician about sub-maximal fitness testing and light-moderate therapeutic exercise.
Scheduling a Med-Fit Tech appointment indicates that you have read and agree to the above Informed Consent.