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March 2015

Health Screening: What You Should Do When Starting a New Exercise Program

by Nick A. Titley, M.S., NPI-Certified Posture Specialist

All of my new clients must perform a health screening process. As a personal trainer and NPI-Certified Posture Specialist™ it’s important that I perform some form of assessment and risk stratification to ensure that my clients are able to meet the demands of the new regimen. Sometimes, clients aren’t able to dive into a new routine because they are considered “high risk” due to a health related issue. In this article, you’ll learn more about the health forms and criteria that can determine your risk levels and what you need to do if you’re considered “high risk”.

If this is the first time you’re reading about health screening or assessments then this is the perfect opportunity for you to learn more. Every personal trainer and health/medical professional should take you through an assessment process. The American College of Sports Medicine website states that fitness assessments will help in the development of individualized training programs and can be used to check for heart disease and other chronic diseases.


Assessments include Medical History forms, a Physical Activities Readiness Questionnaire (PAR-Q), a Cardiovascular Risk Factor form, Informed Consent and a Physician Clearance form. A PAR-Q will determine your readiness to exercise. A medical form will ask for detailed information like blood pressure, obesity, cholesterol levels, heart disease and stroke. It may also ask what medications you’re currently taking.

If you’ve never taken any of these assessments and you’re working with a trainer I suggest you ask them to conduct assessments because they don’t have a solid idea of who you are and run the risk of putting your health in danger.

The American College of Sports Medicine (ACSM) has created a risk stratification form that allows the professional to determine whether you’re low, medium or high risk and in need of modifications or further medical evaluation before beginning your new program.


The ACSM form examines age, family history, cigarette smoking, sedentary lifestyle, obesity, hypertension, diabetes and dyslipidemia (related to cholesterol levels) as criteria for assessing your risk level. In ACSM’s Guidelines for Exercise Testing & Prescription if you have symptoms of cardiovascular disease (CVD), or you’ve been diagnosed with a known cardiovascular, pulmonary or metabolic disease then you’re considered “high risk” and require a physician’s approval before starting an exercise program.

If there are no symptoms of CVD or a diagnosed disease, but you have less than two risk factors then you’re considered “low risk”. If you have two or more risk factors then you’re considered “medium risk”. If you fall into the low or medium risk areas then you don’t require a physician’s approval, but it’s always advised that you still see a health professional if you’re unsure about your wellbeing.

Confused about your risk? Here’s an example: If you’re currently a smoker, obese, live a sedentary lifestyle and may have hypertension and be pre-diabetic, you’re considered "medium risk". If you have only one symptom—sedentary lifestyle or you’re a cigarette smoker— then you’re considered “low risk”. However, if you have heart disease, chest pain, known heart murmur or other signs or symptoms suggestive of a disease then you’re considered "high risk" and need to see a doctor before committing to a program.

If you’re starting a new exercise program I highly suggest you urge your professional to conduct a health screening process to find out more about your medical, fitness and health information as it will give you both a better sense of how your needs can be met while avoiding a problem. Safety is your best bet and knowing your health status is applying that principle.

Personal trainers and health professionals need to conduct a health screening process before starting a new program. If you have a known disease like CVD, or show signs and symptoms of a major problem then you’re considered “high risk” and need physician clearance. If these symptoms and diseases are absent then you could be low or medium risk. It’s advised that you still consult a doctor if you’re starting a new program or you’re unsure about your medical history.



  • Percia, Matthew, Davis Shala PhD, and Gregory R Dwye. "Getting a Professional Fitness Assessment." ACSM | Articles. ACSM, 10 Jan. 2012. Web. 12 Mar. 2015. <acsm.org/access-public-information/articles/2012/01/10/getting-a-professional-fitness-assessment>.
  • Thompson, Walter R. ACSM's Guidelines for Exercise Testing and Prescription. 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2010. Print.
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