Firefighter Fitness Profile

GOLD AND SILVER FIREFIGHTER PROGRAMS
↓ PLEASE START HERE ↓
Attention firefighters! This all-inclusive fitness profile has been developed exclusively for you, and comes FREE with Mike's Custom Gold and Silver Programs. Please complete the entire form before submitting. Thank You!

>> F/F CANDIDATE FITNESS PROFILE

PROGRAM SELECTION
full customization is based on your complete profile


Firefighter: I need to improve my strength and   endurance levels, tone up, and / or lose weight

Firefighter CANDIDATE: I need to build strength and endurance to help pass a CPAT-type test

PICK ONE >>

Firefighter Information: NAME:  
E-MAIL:
PHONE:   - -
SEC. A - YOU AND YOUR GOALS

(1) WHAT ARE YOUR MOST IMMEDIATE GOALS?
Shed Pounds/Inches    Build Job-Specific Strength
Increase Endurance    Improve Performance
Improve My Health     Prepare For Test


(2) GENDER: male female   AGE: yrs

(3) HEIGHT: ft    in  WEIGHT: lbs
    FRAME SIZE: WAIST: in

(4) FIREFIGHTER: Paid Volunteer
    UNIT:   RANK:


(5) CHOOSE YOUR PRIMARY FOCUS TO IMPROVE
Core - Abdominals and Midsection
Lower Body - Thighs, Hips and Glutes
Upper Body - Arms, Shoulders, Chest, Back
Full Body Focus

(5a) DO YOU WANT TO LOSE WEIGHT?


(6) OCCUPATION: (volunteers)

DESCRIBE YOUR NORMAL DAILY ROUTINE?

I normally sit in one place for hours at a time
I'm typically on my feet, but standing in one place
I'm usually moving around or walking all day
I work hard at a variety of activities


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SEC. D - PURCHASE & FORM SUBMISSION
All major credit cards, including PayPal, PayLater accepted!

TAKE THESE 4 SIMPLE STEPS
If you've already made your purchase, skip to step 2

STEP 1: Select one of the 4 payment plans (more info)
LIMITED TIME OFFER: Buy now and get FREE shipping!

      > FF GOLD PLAN ($189)          > FF GOLD E-Z PAY ($63)
2-Phase Fitness and Weight Loss - Includes your Firefighter - Specific Fitness Program, as well as 3 Months Full Support

      > FF SILVER PLAN ($159)       > SILVER E-Z PAY ($53)
2-Phase Pure Fitness - Includes your Firefighter - Specific Fitness Program, as well as 3 Months Full Support


     >> Firefighter Candidates [CLICK HERE]

STEP 2: After payment check that entire profile is filled out

STEP 3: Enter your ORDER NUMBER (also sent via email)
ORDER NUMBER:

STEP 4: Accept following terms, initial and submit


INITIAL:   I Accept the Above Conditions



                

             *Gold buyers be sure to complete section E

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F/F Strength-Skills Checklist

(7) "I need some help with..." (check all that apply)
Overall strength, endurance at fire operations
Long or difficult stretches or large diameter hose
Operation of high pressure hose line
Ascending multiple flights of stairs in full gear
Carrying, lifting heavy equipment long distances
Operation of power tools (IE:roof saw)
Search and rescue operations (crawling)
Transporting, raising and extending heavy ladders
Forcible entry with hand tools (maul, halligan)
Post-control overhaul, breaching celings/walls
Overall grip strength (gloves on)
Recent weight gain interfering with performance
Recovery and soreness after fire operations
LIST OTHER:

SEC. B - PERSONAL PREFERENCES

(8) WHAT IS YOUR FAVORITE MODE OF EXERCISE?
Resistance, also known as strength training
Aerobic also known as cardiovascular training
Yoga, Pilates, stretching or flexibility training
Combination of resistance, cardio, flexibility exercises

(9) WHAT PACE ARE YOU MOST COMFORTABLE WITH?
Faster paced all-inclusive circuit workout
Slower paced traditional type program
Combination of circuit and traditional exercise

(10) DAYS PER WEEK?     TIME EACH DAY?


(11) YOUR LIST OF AVAILABLE EQUIPMENT
Dumbbells Free Weights Weighted Vest Sandbags Fit Ball Medicine Ball Resistance Bands Bench Step Exercise Ball Treadmill Stationary Bike Stepper Elliptical Gym or Health Club Lat Pulldown Low Cable Row Leg Press Smith/Squat Rack Kettlebells Universal
List Other:

SEC. C - FITNESS EVALUATION

(12) HOW OFTEN DO YOU CURRENTLY EXERCISE?
Active -I exercise regularly (3 - 6 times weekly)
Moderate-I exercise occasionally (1-2 times weekly)
Sedentary -I don't currently exercise


(13) WHAT'S YOUR PREVIOUS EXERCISE HISTORY?
Moderate to heavy amounts of strength training
Moderate to heavy amounts of cardio training
Moderate to heavy amounts of flexibility training
I have little or no experience with any exercise

(14) PROBLEM ZONES - CHECK ALL THAT APPLY
I get out of breath going up stairs or rushing for a bus
I have trouble lifting heavy packages that once felt light
I've experienced a recent weight gain (clothes don't fit)
I have no problem with stairs, packages, or weight gain
Overall I consider myself:

(15) ABILITIES PROFILE
Select your ability level in all 3 categories. It's absolutely essential that you answer all questions honestly.

1. How far can you run or jog?

2. How many chest-to-floor push ups* can you do?

*men legs straight, women knees bent

3. How many pull ups or chin ups* can you do?
*pull up or chin up with full arm extension

ANY OTHER INFORMATION OR COMMENTS


How did you hear about us?


SECTION E - WEIGHT MANAGEMENT
Gold Program Only (points 16 to 22)


(16) From the choices below, select the one that best describes your typical eating pattern.
I eat 3 balanced meals daily (plus healthy snacks)
I pick, snack all day, but try to make healthy choices
I pick, snack all day, but pay little attention to calories, nutrition
I tend to not eat all day, then eat too much at once
I usually eat whatever is the most convenient choice

(17) Do you consume a lot of liquid calories in the form of soda, fruit juice, or alcoholic beverages?
I consume little if any liquid calories
At least 3 glasses (8 to 10 oz.) per day
6 glasses (8 to 10 oz.) or more per day

(18) Are you in the habit of adding many additional calories to food and drink in the form of sugar, butter, mayonaise, salad dressing, or gravies?
I add little if any extras
I use with some foods for taste, but always in moderation
I freely add extra calories to food or drink

(19) Explain in your own words, why your previous attempts at weight loss have been only marginally successful.


(20) Are you willing to make a reasonable effort to control eating and increase activity levels?
Yes I feel thoroughly motivated to get started
Yes, but I feel I need help staying on track
No, I want to do this with a minimal effort on my part

(21) What has been your lowest, maintainable body weight
(for at least 6 months) during the past 10 years?

LBS

(22) Do you anticipate support from friends and family?
I plan to do this alone and without too much help
My friends and family will probably be somewhat supportive
I can expect full cooperation from my loved ones