Fitness Law Academy

Enhancing Fitness Safety through Education

Forms and Documents

Proper Use

Fitness managers and exercise professionals are free to use (and edit) any of these forms and documents. All of these forms/documents are “Word” docs that can be easily changed/edited. Some of these forms have “copyright” stated at the bottom. When using/editing these forms in your facility and programs, feel free to remove the copyright statement. However, if you choose to publish any of these forms/documents in print or electronically (e.g., in a book, book chapter, journal article, magazine/newspaper, Internet website, thesis/dissertation), formal permission from Dr. Eickhoff-Shemek ( is required.

Chapter 2 Employee Safety Culture Survey

Chapter 6 PASQ Forms (Appendix 6)


Form 6-1 PASQ Cover Letter

Form 6-2 PASQ – Professionally-Guided

Form 6-3 PASQ Interpretation Form

Form 6-4 PASQ Medical Clearance Form

Form 6-5 PASQ – Self-Guided

See: Putting the New ACSM's Pre-Activity Health Screening Guidelines into Practice

This article includes these PASQ forms, description on how to implement them, and legal issues applicable to pre-activity screening. Please read Chapter 6 and this article before using any of these forms.

Chapter 8 Lesson Plan and Lesson Plan Evaluation Templates

Chapter 8 Performance Appraisal Tool (Appendix 8)

Chapter 10 Incident Report

Chapter 11 Injury Report (Appendix 11)