Waiver & Forms

1. Purpose and Explanation of the Test:

You will perform a graded exercise test on a motor-driven treadmill or stationary upright bike. The exercise intensity will begin at a low level and will be advanced in stages depending on your fitness level. We may stop the test at any time because of signs of fatigue or changes in your heart rate or symptoms you may experience. It is important for you to realize that you may stop when you wish because of feelings of fatigue or any other discomfort.

2. Attendant Risks and Discomforts:

There exists the possibility of certain changes occurring during the test. These include abnormal blood pressure, fainting, irregular, fast or slow heart rhythm, and in rare instances, heart attack, stroke, or death. Every effort will be made to minimize these risks by evaluation of preliminary information relating to your health and fitness and by careful observations during testing.

3. Responsibilities of the Participant:

Information you possess about your health status or previous experiences of heart-related symptoms (such as shortness of breath with low-level activity, pain, pressure, tightness, or heaviness in the chest, neck, jaw, back, and/or arms) may affect the safety of your exercise test. Prompt reporting of these and any other unusual feelings during the test is crucial.

You are responsible for fully disclosing your medical history and symptoms that may occur during the test. You are also expected to report all medications (including non-prescription) taken recently and, in particular, those taken on the day of testing.

4. Benefits to be Expected:

The results obtained from the exercise test will determine your maximal aerobic capacity by scientifically measuring the rate at which oxygen is distributed and utilized by the body during physical activity. A metabolic assessment specialist will discuss your results, and personalized heart rate training zones will be defined.

METAFITRX’s assessment staff are not medical doctors and are not qualified to diagnose a participant’s illness or state of disease.

5. Inquiries:

Any questions about the procedures used in the exercise test or the results of our test are encouraged. If you have any concerns or questions, please ask us for further explanations.

6. Use of Records:

The information obtained during testing will be treated as privileged and confidential. It will not be released or revealed to any person without your approval.

7. Eligibility:

Only individuals determined to be “low risk” based on PAR-Q guidelines may perform maximal testing. Individuals determined to be “moderate risk” may only participate in submaximal testing.

8. Acknowledgement and Consent:

I expressly acknowledge that the exercise test is done for informational purposes and not for diagnosing or treating injuries or illnesses. I hereby consent to voluntarily engage in an exercise test to determine my exercise capacity and state of cardiovascular health. My permission to perform this exercise test is given voluntarily. I understand that I am free to stop the test at any point if I so desire.

1. Voluntary Participation:

I hereby acknowledge that I have voluntarily chosen to participate in the DEXA body composition scan, VO2max exercise test, and/or the Resting Metabolic Rate test through METAFITRX.

2. Non-Medical Disclaimer:

I understand that METAFITRX’s assessment staff are not medical doctors and are not qualified to determine a participant’s physical capability to engage in strenuous exercise.

3. PAR-Q Acknowledgment:

The information provided on the PAR-Q questionnaire is correct to the best of my knowledge. I understand that the absence of physical problems listed on the PAR-Q does not necessarily guarantee that I am in satisfactory health to participate in an exercise test.

4. Acknowledgment of Risk:

I understand and acknowledge the risks involved in participating in all available metabolic assessments at METAFITRX, including, but not limited to, the risks associated with using equipment or engaging in exercise. I have been informed that these risks, though remote, include abnormal blood pressure, fainting, disorders of heart rhythm, stroke, and, in very rare instances, heart attack or even death.

5. Assumption of Risks:

I understand that I am responsible for researching and evaluating the risks that I may face and am responsible for my actions. If I have any doubts about my physical or mental condition, I am responsible for discussing the activities and risks involved during the metabolic assessments with my physician. I agree to expressly assume and accept any and all risks associated with the metabolic assessments, including, but not limited to, travel to/from the testing lab facilities and the limited availability of medical aid.

6. Release, Indemnification, and Hold Harmless:

In consideration of being allowed to participate in the metabolic assessments offered at METAFITRX and to the fullest extent permitted by law, I agree to indemnify, defend, and hold harmless METAFITRX, its trustees, officers, employees, volunteers, agents, and assigns from and against all claims arising out of or resulting from my participation in the exercise test.

I hereby voluntarily release, forever discharge, and agree not to sue METAFITRX, its trustees, officers, employees, volunteers, agents, and assigns from any and all claims, both present and future, that may be made by me, my family, estate, heirs, or assigns.

804.664.6447 | info@metafitrx.com | 7001 Forest Ave, Suite 110 Richmond, VA 23230