To complete this form CLICK HERE to follow our online video tutorial To complete your online medical screening fill out this form whilst watching the online medical screening tutorial and click send at the bottom of the form. Please ensure you complete this test under supervision and ensure you do so in a safe environment. If at any point your experience any sharp pains or feel unwell then cease the medical screening immediately and seek necessary medical support. Name of the person completing the test (required) Mobile Contact (required) Email Address (required) Age (required) TEST 1. KNEE TO WALL - What is the maximum distance on your right and left leg? (required) RIGHT insert here > LEFT insert here > TEST 2. SIT AND REACH TEST - How far can you reach with your fingertips in relation to your toes? – if you can’t reach your toes give the distance as a negative number (e.g. -5cm) if you can reach beyond your toes give the distance as a positive number (4cm) (required) Insert distance here > TEST 3. QUADRICEP LENGTH - Can you touch your bottom with the heel of your foot? (required) RIGHT FOOT YESNO LEFT FOOT YESNO TEST 4. SQUEEZE TEST - Do you feel any pain or discomfort whilst performing this test? (required) YESNO TEST 5. BALANCE TEST - How many times did you touch the floor with the opposite foot whilst balancing on this leg? (required) RIGHT insert here > LEFT insert here > TEST 6. SQUARE HOP - Were you able to maintain balance for 3 consecutive square hops? (required) RIGHT insert here > YESNO LEFT insert here >YESNO TEST 7. HOP AND STICK - What is the furthest distance you were able to jump with the following legs? (required) RIGHT insert here > LEFT insert here > TEST 8. CALF ENDURANCE - How many repetitions for each leg? (required) RIGHT insert here > LEFT insert here > TEST 9. HAMSTRING ENDURANCE - How many repetitions for each leg? (required) RIGHT insert here > LEFT insert here > TEST 10. SINGLE LEG SQUAT ENDURANCE - How many repetitions on each leg? (required) RIGHT insert here > LEFT insert here > TEST 11. FRONT PLANK - How long were you able to maintain correct form (in seconds)? (required) Insert here > TEST 12. SIDE PLANK - How long were you able to maintain correct form with the following elbow on the ground (in seconds)? (required) RIGHT insert here > LEFT insert here >
