Fitomics Discovery Exam Report

First Name:

Last Name:

Date:

Enter Age (Years):

Select Gender:

Enter Height (Inches):

Enter Weight (Pounds):

Enter Body Fat %: examples

SBP (mmHg):

DBP (mmHg):

Resting Heart Rate (bpm):

Goals: Fat Loss, Muscle Gain, or Maintenance:

Fat Mass (lbs):

Fat-Free Mass (lbs):

Fat Mass Index (kg/m²):

Fat-Free Mass Index (kg/m²):

Body Mass Index (kg/m²):

Activity Levels

Activity Level:

Enter Average Calories Expended During a Workout:

Enter Average Workouts Per Week:

Predicted Daily Calorie Burn (kcal):

Estimated Resting Metabolic Rate (RMR):

Measured Resting Metabolic Rate:

% Calories from Fat:

% Calories from Carbohydrate:

Conservative Weight Loss Target (kcal/day):

Aggressive Weight Loss Target (kcal/day):

Conservative Weight Gain Target (kcal/day):

Aggressive Weight Gain Target (kcal/day):

Strength Measurements

Grip Strength Left (kg):

Grip Strength Right (kg):

Average Grip Strength (kg):

10RM - Bench:

10RM - Chop:

10RM - Pulldown:

10RM - DL:

Upper Strength Score (Percentile Rank):

Lower Strength Score (Percentile Rank):

Core Strength Score (Percentile Rank):

Total Strength Score (Percentile Rank):

Cardiovascular Measurements

Please chose either Cooper or Storer, but not both

6 min Distance (Miles):

Cooper VO2 Max (ml/kg/min):

Watts at Peak Workload (Storer, 1990):

Ending Heart Rate (bpm):

1-minute Post Heart Rate (bpm):

Bike/Storer VO2 Max (ml/kg/min):

Results:

Protein (grams/kilogram of FFM):

Fat (Percent of Calories):

Nutrient	Value	Calculated Amount	Calculated Calories
Target Energy Range (kcal)
Protein
Fat
Carbs
Fiber
Fluid Intake

Fitomics Discovery Exam Report

Please enter data into the blue shaded fields. Red fields will populate with calculated values

Demographics and Vitals

Activity Levels

Strength Measurements

Cardiovascular Measurements

Results: