Name of interviewer: George Date: 03/10/2019
Alexander
Unit 7: Assignment 2 – Task 1
Health Screening Questionnaire – Assignment 2: Task 1
P2 Prepare an appropriate health screening questionnaire
P3 Devise and use appropriate health screening procedures for two contrasting individuals
Personal Information
Harry Holmes
Name
Male
Gender
16
Age
21/03/03
DOB
72
Resting HR
Yes
Informed
Consent?
125
Blood
Pressure
Stages of Change
Pre-Contemplation
Contemplation
Preparation
Action
Maintenance
Relapse
Client Interview
, 1. Are you currently on any medication?
No
2. What made you want to start training?
I wanted to improve my cardio-vascular endurance.
3. What are your personal fitness goals/ aspirations?
To improve my long distance events such as running and cycling.
4. How many times a week can you commit to training?
I can commit 4 times a week.
5. How long can you spend doing each session?
I can spend 3 hours doing each session.
6. What is your occupation and hours of work?
School, 10-3 30
7. How would you rate your current stress level out of 10?
1
8. Do you have any cultural differences that may affect your programme?
No I do not
9. What are your personal nutrition goals/ aspirations?
Alexander
Unit 7: Assignment 2 – Task 1
Health Screening Questionnaire – Assignment 2: Task 1
P2 Prepare an appropriate health screening questionnaire
P3 Devise and use appropriate health screening procedures for two contrasting individuals
Personal Information
Harry Holmes
Name
Male
Gender
16
Age
21/03/03
DOB
72
Resting HR
Yes
Informed
Consent?
125
Blood
Pressure
Stages of Change
Pre-Contemplation
Contemplation
Preparation
Action
Maintenance
Relapse
Client Interview
, 1. Are you currently on any medication?
No
2. What made you want to start training?
I wanted to improve my cardio-vascular endurance.
3. What are your personal fitness goals/ aspirations?
To improve my long distance events such as running and cycling.
4. How many times a week can you commit to training?
I can commit 4 times a week.
5. How long can you spend doing each session?
I can spend 3 hours doing each session.
6. What is your occupation and hours of work?
School, 10-3 30
7. How would you rate your current stress level out of 10?
1
8. Do you have any cultural differences that may affect your programme?
No I do not
9. What are your personal nutrition goals/ aspirations?
