University of Minnesota
Physical Activity Documentation Template
Current exercise or physical activity:
Activities: ***
Days per week: ***
Duration: ***
Reasons to increase activity: {select from dropdown list}
• Health
• Mood
• Family
• Friends
• Self-worth
• Appearance
• Social activities
• Clothes fit better
• Other
Barriers to regular activity: {select from dropdown list}
• Safe place to exercise
• Feeling too tired
• Low motivation
• Lacking time
• Pain
• Lack of exercise buddy
• Lack of money/resources
• Don’t know what to do
• Embarrassment/shame
• Dislike exercise
• Other
Plan: Ask patient to write specific goal on back page of handout.
Activity: ***
Frequency: ***
Duration: ***
Buddy: ***
Follow up ***
Change that Matters Being Physically Active handout given.
*** minutes spent counseling patient regarding physical activity to improve overall health.
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- sample school policies template
- wisconsin guardianship association
- disability look after children oohc guide
- physical planning regulation 1990 fao
- university of minnesota
- local court practice note no comm 1
- clothing matters what we wear to church
- physical planning act 1989 fao
- how to annotate in your english class
- create professional legal documents for your website or
Related searches
- university of minnesota education department
- university of minnesota education depart
- university of minnesota college of education
- university of minnesota school of social work
- university of minnesota education program
- university of minnesota cehd
- university of minnesota adult education
- university of minnesota elementary education
- university of minnesota special education
- university of minnesota teaching license
- university of minnesota degree programs
- university of minnesota ceu