CLIENT

ASSESSMENT
MATRIX
Name: Carl
Determining
Risk
Is CV,
pulmonary or
metabolic
disease
present?
List clients
major signs
or symptoms
of CV,
pulmonary,
or metabolic
disease. If
none
present,
indicate N/A
Identify
clients ris
factors for
C!". If none,
indicated N/A.
Is client at
lo# or
moderate
ris and is
p$ysician
consent
re%uired?
&$y or #$y
not?
ANSWERS Go
in this row
----
'es (IA Could $a)e a
ast$ma attac
during
e*ercise
Lo# ris as
long as $e
uses $is
in$aler
EXERCISE an!
"ITNESS
NEEDS
If yes,
describe
$o#.
Needs to add
muscular
#eig$t
training. And
increase $is
cardio
training.
If no,
describe #$y
not.
&$at are t$e
minimum
e*ercise
recommendati
ons for t$is
client based
upon t$e
+uidelines?
,-. mins. /f
mod. Intensity
aerobic e)ery
#ee and on 0
days a #ee
mucle1
strengt$ening
acti)ities.
Needs
Impro)eme
nt? 2ro)ide
a concrete
goal for t$is
component.
&$at
c$anges
does client
need to
mae to
bring
e*ercise
le)els in line
#it$
+uidelines?
If client is
meeting t$e
+uidelines,
indicate
N/A.
Does the
#lient
#$rrentl%
No 3ust add
mucle1
strengt$eni
meet the
minim$m
re#ommen!at
ions &or
e'er#ise(
ng and
more cardio
CLIENT
ASSESSMENT
MATRIX
Name: Sall%
Determining
Risk
Is CV,
pulmonary or
metabolic
disease
present?
List clients
major signs
or symptoms
of CV,
pulmonary,
or metabolic
disease. If
none
present,
indicate N/A
Identify
clients ris
factors for
C!". If none,
indicated N/A.
Is client at
lo# or
moderate
ris and is
p$ysician
consent
re%uired?
&$y or #$y
not?
ANSWERS go
in this row
---
yes 4ype 0
diabetes and
$ypertension
!ig$ fat 5,
diabetes, and
$ypertension
3od. 6is
and yes
needs a
p$ysician
release
EXERCISE an!
"ITNESS
NEEDS
If yes,
describe
$o#.
'es, needs to
start a cardio
training
program #it$
a little
#eig$t
training
If no,
describe #$y
not.
&$at are t$e
minimum
e*ercise
recommendati
ons for t$is
client based
upon t$e
+uidelines?
,-. mins. /f
mod. Intensity
cardio acti)ity
and 0 days of
strengt$ening
t$e muscles.
Needs
Impro)eme
nt? 2ro)ide
a concrete
goal for t$is
component.
&$at
c$anges
does client
need to
mae to
bring
e*ercise
le)els in line
#it$
+uidelines?
If client is
meeting t$e
+uidelines,
indicate
N/A.
Does the
#lient
#$rrentl%
meet the
minim$m
re#ommen!at
ions &or
e'er#ise(
No 7tart
#aling 8 to
- days a
#ee for 8.
mins. And
use
mac$ines
for muscles
CLIENT
ASSESSMENT
MATRIX
Name:
)enni&er
Determining
Risk
Is CV,
pulmonary or
metabolic
disease
present?
List clients
major signs
or symptoms
of CV,
pulmonary,
or metabolic
disease. If
none
present,
indicate N/A
Identify
clients ris
factors for
C!". If none,
indicated N/A.
Is client at
lo# or
moderate
ris and is
p$ysician
consent
re%uired?
&$y or #$y
not?
ANSWERS go
in this row
---
yes /besity, $ig$
blood
pressure
!ig$ blood
pressure
3od. 6is
and needs
to be
cleared by a
doctor
EXERCISE an!
"ITNESS
NEEDS
If yes,
describe
$o#.
'es, s$e
currently $as
no e*ercise
program in
place
If no,
describe #$y
not.
&$at are t$e
minimum
e*ercise
recommendati
ons for t$is
client based
upon t$e
+uidelines?
Needs
Impro)eme
nt? 2ro)ide
a concrete
goal for t$is
component.
&$at
c$anges
,-. mins. /f
cardio, and 0
days a #ee
of muscle1
strengt$ening
does client
need to
mae to
bring
e*ercise
le)els in line
#it$
+uidelines?
If client is
meeting t$e
+uidelines,
indicate
N/A.
Does the
#lient
#$rrentl%
meet the
minim$m
re#ommen!at
ions &or
e'er#ise(
no Needs to
start t$e
min.
reguirement
s of
cardio/musc
le training
CLIENT
ASSESSMENT
MATRIX
Name:
)$stin
Determining
Risk
Is CV,
pulmonary or
metabolic
disease
present?
List clients
major signs
or symptoms
of CV,
pulmonary,
or metabolic
disease. If
none
present,
indicate N/A
Identify
clients ris
factors for
C!". If none,
indicated N/A.
Is client at
lo# or
moderate
ris and is
p$ysician
consent
re%uired?
&$y or #$y
not?
ANSWERS go
in this row
---
no obesity &eig$t is a
ris factor
Lo#, doctor
release not
needed
EXERCISE an!
"ITNESS
NEEDS
If yes,
describe
$o#.
'es, sports
and #eig$t
training
If no,
describe #$y
not.
&$at are t$e
minimum
e*ercise
recommendati
ons for t$is
client based
upon t$e
+uidelines?
9. mins a day
of p$ysical
acti)ity #$ic$
s$ould include
strengt$ening
t$e muscles
#it$ some
#eig$t
training
Needs
Impro)eme
nt? 2ro)ide
a concrete
goal for t$is
component.
&$at
c$anges
does client
need to
mae to
bring
e*ercise
le)els in line
#it$
+uidelines?
If client is
meeting t$e
+uidelines,
indicate
N/A.
Does the
#lient
#$rrentl%
meet the
minim$m
re#ommen!at
ions &or
e'er#ise(
7trengt$
training 8
days a #ee
and p$ysical
acti)ity
daily for 9.
mins.