Background Information
Indicate NIL if not applicable
Basic Health Survey
(e.g. jogging, swimming, cycling, brisk walking, playing soccer, basketball and dancing)
(For example, 3-in-1 coffee or tea, soft drinks, fruit drinks/juices, packet drinks, milo, cordials)
(For example: ordering less sugar at the drinks stall, instant coffee with less sugar, reduced sugar or no sugar in soy milk)
(e.g. dishes with HPB's healthier choice symbol, 500kcal meals, meals with healthier substitutes)
My goals
My goals for the next fitness measurement:
I want to improve the following... (Choose at most 2 from each category)
How will I do it?
How will I do it?
How will I do it?
How will I do it?
How will I do it?
How will I do it?
Join Get Fit! 12 weeks programme and improve in Body Weight Strength Assessment.
How will I do it?
Safety & Personal Data Release Agreement:
Safety:
Personal Data Release Agreement: