会员姓名 Name : __
会员号码 Membership No.:
__
为阁下安全，请回答以下问题（在适用处 打上9号） For your safety, please answer the following questions by ticking (9) the appropriate box ( )
Classification
坐式前弯 Trunk Forward Flexion (inch) 评级 Classification
身体柔韧度 Body Flexibility
5
估计脂肪百分比(男性)Percent Fat Estimations For Men
皮折量度数值总和
Sum of three skinfolds 18-22
• take part in a fitness appraisal - this is an • 进行体适能评估 (这是最好的方法测试你现在 excellent way to determine your basic 体适能状况，因此你能更有效计划你的健康生 fitness so that you can plan the best way 活。) for you to live actively.
2. 当你进行运动时，胸腔有否感到痛楚？
Do you feel pain in your chest when you do physical activity? 3. 在过往一个月，你曾否试过在没有运动情况下出现胸腔痛楚感觉？
In the past month, did you have chest pain when you were not
Abdomen 大腿
Suprailium 大腿
Thigh 总数 (毫米)
Thigh
Total (mm) 估计体脂百分比
Estimated Body Fat 评级
Classification 电子测量
% Body Fat (BIA) 腰臀比例
Waist-hip ratio 评级
Classification
28.2
29.0
29.1
29.9
30.0
30.8
30.8
31.6
31.6
32.4
32.4
33.1
33.0
33.8
33.7
34.4
34.2
35.0
34.8
35.5
35.2
36.0
35.6
36.4
36.0
36.8
36.3
37.1
36.6
37.4
36.8
37.6
36.9
37.7
37.0
37.8
43-47 5.7 7.6 9.3 11.1 12.8 14.4 15.9 17.5 18.9 20.3 21.7 23.0 24.3 25.5 26.6 27.7 28.8 29.8 30.7 31.6 32.4 33.2 33.9 34.6 35.2 35.8 36.3 36.8 37.2 37.6 37.9 38.1 38.4 38.5 38.6
Classification 体重 (公斤) Body Weight (kg) 体重指数
BMI 评级
Classification
体脂百分比 - 皮折测量 Body Composition - % Body Fat (Skinfold)
男 胸部
女
肱三头肌
Men Chest 腹部
Women Triceps 髂嵴上缘
48-52 6.5 8.4 10.1 11.9 13.5 15.2 16.7 18.3 19.7 21.1 22.5 23.8 25.1 26.3 27.4 28.5 29.6 30.5 31.5 32.4 33.2 34.0 34.7 35.4 36.0 36.6 37.1 37.6 38.0 38.4 38.7 38.9 39.1 39.3 39.4
健康和体适能评估表集 Health and Fitness Assessment Kit
专业体适能教练专用 For Professional Fitness Trainer
1
身体状况安全问卷调查 PAR-Q FORM
(为年龄介乎１５至６９人士之问卷) (A Questionnaire for People Aged 15 to 69)
4
上身肌力及肌耐力测试 Upper Body Muscular Strength & Endurance
测试日期 Test Date
1st
2nd
3rd
4th
最多俯卧撑次数
Maximum No. of push-ups 评级
Classification 20 秒卷腹次数
No. of crunch completed in 20 sec 评级
25.8
98-102
26.7
103-107
27.6
108-112
28.5
113-117
29.3
118-122
30.0
123-127
30.7
128-132
31.3
133-137
31.9
138-142
32.4
143-147
32.9
148-152
33.3
153-157
33.6
158-162
33.9
163-167
28-32 3.4 5.2 7.0 8.7 10.4 12.0 13.6 15.1 16.6 18.0 19.3 20.6 21.9 23.1 24.3 25.3 26.4 27.4 28.3 29.2 30.1 30.8 31.6 32.2 32.9 33.4 34.0 34.4 34.8 35.2 35.5 35.8 36.0 36.1 36.2
If you answered NO honestly to all PAR-Q 若你真实地回答所有的问题，并所有的答案是
questions, you can be reasonably sure that 「没有」。你能够: you can:
• start becoming much more physically active • 进行运动 (但要在开始时将强度降低，并逐渐 - begin slowly and build up gradually. This 提高。这是最安全及最容易的方法。) is the safest and easiest way to go.
8-12
1.8
13-17
3.6
18-22
5.4
23-27
7.1
28-32
8.8
33-37
10.4
38-42
12.0
43-47
1
16.4
58-62
17.8
63-67
19.1
68-72
20.3
73-77
21.5
78-82
22.7
83-87
23.8
88-92
24.8
93-97
• 你或许能进行任何运动，但要在开始时将强度 降低，并逐渐提高。或你可能限制只能参与对 你安全的运动。咨询你的医生有关你希望参与 的运动，并参考医生的意见。
• Find out which community programs are • 寻找对你合适与安全的社会康体计划 safe and helpful for you.
53-57 7.3 9.1 10.9 12.6 14.3 15.9 17.5 19.0 20.5 21.9 23.3 24.6 25.8 27.0 28.2 29.3 30.3 31.3 32.3 33.2 34.0 34.8 35.5 36.2 36.8 37.4 37.9 38.4 38.8 39.2 39.5 39.7 39.9 40.1 40.2
日期 Date
2
Instruction of PAR-Q
身体状况安全问卷调查使用指引
If you answered yes to one or more questions 若「有」的答案有一个彧以上
Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-O and which questions you answered YES.
年龄 Age(years)
33-37
38-42
4.2
4.9
6.0
6.8
7.8
8.6
9.5
10.3
11.2
12.0
12.8
13.6
14.4
15.2
15.9
16.7
17.4
18.1
18.8
19.6
20.1
20.9
21.4
22.2
22.7
23.5
23.9
24.7
25.0
25.8
26.1
26.9
27.2
28.0
3
健康和体适能评估表
姓名 Name 住址 Address 身高(米) Body Height (m)
个人资料
Personal Information
会员号码 Membership no. 男/女 Male/Female 年龄 Age:
测试日期
項目
Test Date 1st
2nd
3rd