Exercise Physiologist Skills Checklist

Requested by:

Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

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PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS:

Proficiency

I have never done the stated task.
I have performed the task/skill infrequently; I require more experience/practice to feel comfortable and proficient.
I have performed the task/skill several times and feel moderately comfortable functioning independently but would require a resource person nearby.
I have performed the task/skill frequently and would feel very comfortable and proficient performing it without supervision or practice.

Frequency

PATIENT RIGHTS *

	SKILL		FREQUENCY
Communicate and obtain information while respecting patient rights, privacy, and confidentiality of information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Involve the patient and family and respect their role in determining the nature of care to be provided
Provide accurate information to patients and families in a timely manner

ASSESSMENT AND EVALUATION *

	SKILL		FREQUENCY
Body Composition Analysis (BMI)
Cardiovascular fitness testing
Muscular strength and endurance testing
Flexibility testing
Balance testing

GENERAL RESPONSIBILITIES *

	SKILL		FREQUENCY
Create and implement workout regimens for people with diverse health issues and levels of fitness
Delivering guidance and instruction on nutrition, exercise, and physical fitness
Monitor client progress, adjusting exercise plans as necessary
Collaborate with healthcare professionals to give patients complete care, including doctors, physical therapists, and dieticians
Conduct research and assist in the creation of interventions and programs linked to exercise and fitness
Monitor workouts and offer advice on good form and technique
Monitoring and tracking client progress using workout gear and technology like heart rate monitors and fitness trackers
Keep precise and thorough client records
Keep abreast of developments in research and fashion in the realms of exercise physiology and allied disciplines
Knowledge in stretching techniques
Knowledge of anatomy and physiology
Knowledge of massage

EQUIPMENT *

	SKILL		FREQUENCY
Treadmills
Stationary bikes
Ellipticals
Weighing machines
Free weights
Resistance bands
Exercise balls
Heart rate monitors
Fitness trackers
Computer programs and software
Body composition analyzers
Athletic taping
Kinesiology taping
McConnell taping
Dynamic taping
Power taping
Mulligan taping
Microsoft Excel
Microsoft Word
Microsoft Powerpoint

ELECTRONIC DOCUMENTATION *

AGE SPECIFIC COMPETENCIES *

	SKILL		FREQUENCY
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)

Attestation

ATTESTATION: *

I certify that the information provided above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *