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  • HRMD 11F Physical Agility Form Rev01

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    Pauline Joy Pascual
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    This document is a physical agility test form from the Bureau of Fire Protection in the Philippines. It contains spaces to record a test taker's name, region, age, sex, initial vitals like height, weight, blood pressure and BMI. It also includes spaces to note if they pass an initial GO/No-GO screening and any remarks from an EMS safety officer. The main part of the form lists different physical events like pull-ups, push-ups, sit-ups, flatter kick, 100-meter dash and a 3km endurance run with spaces to record scores and points for each. At the bottom it has a space to note the total points, whether the test taker passed or

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    This document is a physical agility test form from the Bureau of Fire Protection in the Philippines. It contains spaces to record a test taker's name, region, age, sex, initial vitals like height, weight, blood pressure and BMI. It also includes spaces to note if they pass an initial GO/No-GO screening and any remarks from an EMS safety officer. The main part of the form lists different physical events like pull-ups, push-ups, sit-ups, flatter kick, 100-meter dash and a 3km endurance run with spaces to record scores and points for each. At the bottom it has a space to note the total points, whether the test taker passed or

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    47 views1 page

    HRMD 11F Physical Agility Form Rev01

    Uploaded by

    Pauline Joy Pascual
    This document is a physical agility test form from the Bureau of Fire Protection in the Philippines. It contains spaces to record a test taker's name, region, age, sex, initial vitals like height, weight, blood pressure and BMI. It also includes spaces to note if they pass an initial GO/No-GO screening and any remarks from an EMS safety officer. The main part of the form lists different physical events like pull-ups, push-ups, sit-ups, flatter kick, 100-meter dash and a 3km endurance run with spaces to record scores and points for each. At the bottom it has a space to note the total points, whether the test taker passed or

    Copyright:

    © All Rights Reserved
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    of 1

    Republic of the Philippines

    Department of the Interior and Local Government


    BUREAU OF FIRE PROTECTION
    NATIONAL HEADQUARTERS
    Agham Road, Barangay Bagong Pag-asa, Quezon City

    PHYSICAL AGILITY TEST


    (FO1/LATERAL ENTRY)

    Name: ___________________________________________ Date: ________________

    Region: ________________ Age: ________ Sex: ________

    INITIAL VITALS

    Height (m): _________ Weight (kg): __________ BP: _________ BMI: ________

    GO/No-GO: ___________ Remarks/Diagnosis: _____________________________

    Signature of Examinee EMS Safety Officer

    Passing Score: 75 Points

    EVENT SCORE/TIME POINTS REMARKS

    Pull-ups/Hanging

    Push-ups (1 min.)

    Sit-ups (1 min.)

    Flatter Kick

    100-Meter Dash

    3km Endurance Run

    TOTAL

    FINAL RESULT (Pass/Fail): _______________________

    PAT Officer

    BFP-QSF-HRMD-011 Rev. Ø1 (02.09.23)

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