Fitness Survey

By Lynn Rohrs, Lead Consultant, Academic Information Systems, Columbia University.

Thank you for agreeing to participate in this study. Please be assured that your identity will be carefully guarded, we use your name on this form only for administrative purposes.

ID Number ________________

I. Personal Information

II. Fitness Measures

                  Starting         Ending

      Weight    ____________    _____________

   Pulse Rate   ____________    _____________

    Skinfold    ____________    _____________

III. Exercise Measures

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