Name:

Email:
POST-SURVEY (please complete!!)
1) How would you rate your fitness? (1 = Least fit, 5 = most fit)
2) How many days on average per week do you work out?
3) On days you do work out, is it A) less than 30 min,
B) 30 min - 1 hour, or C) greater than 1 hour

PRETEST (complete anytime WEEK 1)

Note: All of the pretest items, (like this entire sheet) are OPTIONAL. Fill in only what you wan
Have a better metric for pre/post-test? Fill it in! Just try to complete the same category/ies fo
Furthest distance run in 5 minutes
Time to complete 5K (3.1 miles)
Distance pedaled on stationary bike in 10 minutes
Distance swam in 10 minutes
# of pushups completed in 1 min
# of situps completed in 1 min
How long can you hold a plank?
Average # of days you stretch per week
Average amount of time you stretch per day
Additional Option: Spartan 30 day Training Program:
Additional Option: Batman 30 day Training Program:

Week 1 (4/13 - 4/19)

# of days Cardio > 30 minutes
# of days Strength Training > 30 minutes

Bonus points! Exam week for you? (

# of days Flexibility Training > 15 minutes

Week 2 (4/20 - 4/26)

Bonus points! Exam week for you? (

# of days Cardio > 30 minutes

# of days Strength Training > 30 minutes
# of days Flexibility Training > 15 minutes

Week 3 (4/27 - 5/3)

Bonus points! Exam week for you? (

# of days Cardio > 30 minutes

# of days Strength Training > 30 minutes
# of days Flexibility Training > 15 minutes

Week 4 (5/4 - 5/10)

Bonus points! Exam week for you? (

# of days Cardio > 30 minutes

# of days Strength Training > 30 minutes
# of days Flexibility Training > 15 minutes

Week 5 (5/11 - 5/17)

Bonus points! Exam week for you? (

# of days Cardio > 30 minutes

# of days Strength Training > 30 minutes
# of days Flexibility Training > 15 minutes

Week 6 (5/18 - 5/24)

# of days Cardio > 30 minutes

Bonus points! Exam week for you? (

# of days Strength Training > 30 minutes

# of days Flexibility Training > 15 minutes

POSTTEST (complete anytime WEEK 6)

Note: All of the posttest items, (like this entire sheet) are OPTIONAL. Fill in only what you wa
Have a better metric for pre/post-test? Fill it in! Just try to complete the same category/ies fo
Furthest distance run in 5 minutes
Time to complete 5K (3.1 miles)
Distance pedaled on stationary bike in 10 minutes
Distance swam in 10 minutes
# of pushups completed in 1 min
# of situps completed in 1 min
How long can you hold a plank?
Average # of days you stretch per week
Average amount of time you stretch per day

# of days completed in Spartan Training (max 30)

# of days completed in Batman Training (max 30)

POST-SURVEY (please complete!!)

1) How would you rate your fitness? (1 = Least fit, 5 = most fit)
2) How many days on average per week do you work out?
3) On days you do work out, is it A) less than 30 min,
B) 30 min - 1 hour, or C) greater than 1 hour
4) Do you feel the Fitness Challenge improved your fitness?

(1 = No improvement, 5 = Most improvement)

5) Would you participate in a challenge like this again?
(1 = Definitely would not, 5 = Definitely would)

Please email your form back to shanep@brown.edu by May 25th in order to be eligible for a p

SHC would like to thank the Brown Medical Alumni Association for its generous support of the

(1-5)
days

(A or B or C)

IONAL. Fill in only what you want. The more you fill in, the easier it may be to measure, but the choice
mplete the same category/ies for both pre AND post.
miles
minutes
miles
meters
pushups
situps
seconds
days
minutes
http://info.spartan.com/30-day-training-plan/
http://starecat.com/batman-30-day-challenge-squats-push-ups-sit-ups/

us points! Exam week for you? (Y/N)

days
days

Total time this week in Cardio:

Total time this week in Strength:

days

Total time this week in Flexibility:

us points! Exam week for you? (Y/N)

days
days
days

Total time this week in Cardio:

Total time this week in Strength:
Total time this week in Flexibility:

us points! Exam week for you? (Y/N)

days
days
days

Total time this week in Cardio:

Total time this week in Strength:
Total time this week in Flexibility:

us points! Exam week for you? (Y/N)

days
days
days

Total time this week in Cardio:

Total time this week in Strength:
Total time this week in Flexibility:

us points! Exam week for you? (Y/N)

days
days
days

Total time this week in Cardio:

Total time this week in Strength:
Total time this week in Flexibility:

us points! Exam week for you? (Y/N)

days

Total time this week in Cardio:

days
days

Total time this week in Strength:

Total time this week in Flexibility:

TIONAL. Fill in only what you want. The more you fill in, the easier it may be to measure, but the choice
mplete the same category/ies for both pre AND post.
miles
minutes
miles
meters
pushups
situps
seconds
days
minutes

days
days

(1-5)
days

(A or B or C)

(1-5)

(1-5)

5th in order to be eligible for a prize!

n for its generous support of the Fitness Challenge!

sure, but the choice is up to you!

minutes
minutes

minutes

minutes
minutes
minutes

minutes
minutes
minutes

minutes
minutes
minutes

minutes
minutes
minutes

minutes

minutes
minutes

asure, but the choice is up to you!