Physical Evaluation Test

1. I can build kitchen cabinets

Yes

No

Not Sure

N/A

2. I am physically fit

Yes

No

Not Sure

N/A

3. I can lift 30-60

Yes

No

Not Sure

N/A

4. I work out daily

Yes

No

Not Sure

N/A

5. I do recreational drugs

Yes

No

Not Sure

N/A

6. I have an exercise routine

Yes

No

Not Sure

N/A

7. Sometimes I get bad headaches

Yes

No

Not Sure

N/A

8. I have allergies

Yes

No

Not Sure

N/A

9. I can be clumsy sometimes

Yes

No

Not Sure

N/A

10. I feel like I'm getting old

Yes

No

Not Sure

N/A

11. I love to take walks

Yes

No

Not Sure

N/A

12. I can stand on my feet consistently for 8 hours

Yes

No

Not Sure

N/A

13. I can lift 10-20 pounds

Yes

No

Not Sure

N/A

16. I have backaches

Yes

No

Not Sure

N/A

14. I like lifting boxes

Yes

No

Not Sure

N/A

15. I smoke cigarettes

Yes

No

Not Sure

N/A

17. I run every morning

Yes

No

Not Sure

N/A

18. I have great balance

Yes

No

Not Sure

N/A

19. I have asthma

Yes

No

Not Sure

N/A

22. I have high blood pressure

Yes

No

Not Sure

N/A

23. I'm between the ages of 18 and 25

Yes

No

Not Sure

N/A

20. I smoke marijuana

Yes

No

Not Sure

N/A

21. I have minor health problems

Yes

No

Not Sure

N/A

24. I have great balance

Yes

No

Not Sure

N/A

25. I have back problems

Yes

No

Not Sure

N/A

26. I am between the ages of 25-40

Yes

No

Not Sure

N/A

27. I have sinus issues

Yes

No

Not Sure

N/A

28. I have no back problems

Yes

No

Not Sure

N/A

How much do you weigh?

How old are you?

What are the max pounds that you know for sure you can pick up?

Have you ever worked at a warehouse job?

Yes

No

How do you feel about your physical ability? Why?

How do you feel about physical labor? Why?

How do you feel about landscaping? Why?

15 July 2020

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