I understand that the purpose of the
exercise program is to develop and maintain
cardiorespiratory fitness, body composition,
flexibility, muscular strength and endurance. A
specific exercise plan will be given to me, based on
my needs and abilities. All exercise
prescription components will comply with proper
exercise program protocols. The programs include,
but are not limited to aerobic exercise, flexibility
training, and strength training. All programs are
designed to place a gradually increasing workload on
the body in order to improve overall fitness.
Risks
I understand, and have been
informed, that there exists the possibility of
adverse changes when engaging in a physical activity
program. I have been informed that these changes
could include abnormal blood pressure, fainting,
disorders of heart rhythm, stroke and very rare
instances of heart attack or even death. I have been
told that every effort will be made to minimize
these occurrences by proper screening and by
precautions and observations taken during the
exercise session. I understand that there is a risk
of injury, heart attack, or even death as a result
of my participation in an exercise program, but
knowing those risks, it is my desire to partake in
the recommended activities.
Benefits
I understand that participation in
an exercise program has many health related
benefits. These may include improvements in body
composition, range of motion, musculoskeletal
strength & endurance, and cardiorespiratory
efficiency. Furthermore regular exercise can improve
blood pressure and lipid profile, metabolic
function, and decreases the risk of cardiovascular
disease.
Physiological Experience
I have been informed that during my
participation in the exercise program I will be
asked to complete physical activities that may
elicit physiological responses/symptoms that include
but not limited to the following: elevated heart
rate, elevated blood pressure, sweating, fatigue,
increased respiration, muscle soreness, cramping,
nausea, .
Confidentiality and Use of
Information
I have been informed that the
information obtained in this exercise program will
be treated as privileged and confidential and will
consequently not be released or revealed to any
person without my express written consent. Any other
information obtained, however, will be used only by
the program staff to evaluate my exercise status as
needed.
Inquiries and Freedom of Consent
I have been given an opportunity to
ask questions about the exercise program. I further
understand that there are also other remote health
risks. Despite the fact that a complete accounting
of all these remote risks has not been provided to
me, I still desire to proceed with the exercise
program. I acknowledge that I have read this
document in its entirety or that it has been read to
me if I have been unable to read same. I consent to
the rendition of all services and procedures as
explained herein by all program personnel.
