OptiHealth Institute
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Therapeutic Lifestyle Certificate
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Home
About Us
Donate / Sponsor
Contact Us
Disclaimer
Courses
Therapeutic Lifestyle Certificate
Recreation Coordinator
Medical-Fitness Technician
Medical-Nutrition Technician
Therapeutic Lifestyle Coach
Church-Based Health Evangelist
Alumni
Med-Fit Scores & Exercise Rx
Instructions:
Submit the form below after completing your free baseline Medical-Fitness Assessment at your local Med-Fit Clinic.
*
Indicates required field
Name:
*
First
Last
Email:
*
Name of Med-Fit Clinic:
*
Date of Med-Fit Assessment
*
MM/DD/YYYY
Gender:
*
Male
Female
Age:
*
In Years and Months (YY.MM).
Height:
*
In Feet & Inches.
Weight:
*
In Pounds.
Body Mass Index (BMI):
*
Aerobic Endurance Format:
*
Outdoor Shuttle
Indoor Treadmill
Score on 4-Minute Jog/Walk:
*
Score on 3-Minute Squats:
*
Score on 2-Minute Leg-Raises:
*
Score on 1-Minute Push-Ups:
*
Overall Fitness Score:
*
Exercise Rx:
*
Write a brief Review of your initial (baseline) Med-Fit Assessment experience:
*
Submit
Course Syllabus